Health Care Effect of Disease-Modifying Antirheumatic Drug Use on Patients with Rheumatoid Arthritis
| Autor: | Kim Saverno, Ritupurna Bhattacharya, Carol L. Gaich, Natalie N. Boytsov, Laurin Dixon, Xiang Zhang, Radhika Nair, Paul L Abbott |
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| Rok vydání: | 2019 |
| Předmět: |
Male
musculoskeletal diseases medicine.medical_specialty Prescription Drugs medicine.medical_treatment MEDLINE Pharmaceutical Science Arthritis Pharmacy Arthritis Rheumatoid 03 medical and health sciences 0302 clinical medicine Internal medicine Health care Humans Medicine 030212 general & internal medicine Disease-modifying antirheumatic drug skin and connective tissue diseases Aged Retrospective Studies Biological Products business.industry 030503 health policy & services Health Policy Anti-Inflammatory Agents Non-Steroidal Retrospective cohort study Health Care Costs Patient Acceptance of Health Care medicine.disease Antirheumatic Agents Rheumatoid arthritis Female Observational study 0305 other medical science business Antirheumatic drugs |
| Zdroj: | Journal of Managed Care & Specialty Pharmacy. 25:879-887 |
| ISSN: | 2376-1032 2376-0540 |
| DOI: | 10.18553/jmcp.2019.25.8.879 |
| Popis: | Disease-modifying antirheumatic drugs (DMARDs) are recommended as the standard of care for patients with rheumatoid arthritis (RA) due to their ability to reduce pain and disability; however, DMARD use is low in some subgroups of the RA population.To identify characteristics associated with DMARD use in the overall cohort of patients with RA and newly diagnosed RA patients.This retrospective observational study used claims from a large national health plan. Use of DMARDs was measured according to the Healthcare Effectiveness Data and Information Set (HEDIS) as the proportion of patients with RA receiving DMARDs. Following HEDIS measure technical specifications, we identified patients aged 18-89 years with continuous enrollment during 2014 (measurement year) with ≥ 2 claims for RA outpatient visits and/or discharges on different dates between January and November 2014. Additionally, we identified a subset of patients newly diagnosed with RA in 2014 based on absence of any claims for RA or DMARDs in 2013. Descriptive analyses and bivariate associations were used to compare demographic and clinical characteristics of patients with RA with or without DMARD use in 2014. Health care resource utilization (HCRU) and costs were compared in 2014 for patients enrolled in Medicare Advantage Prescription Drug (MAPD) plans during both 2014 and 2015. Regression models were used to evaluate patient and provider characteristics associated with DMARD use in 2014 and the effect on HCRU and costs.Among the 33,880 patients identified with RA in 2014, most patients received a DMARD (75.2%); 29.4% of patients newly diagnosed with RA had been treated with DMARDs in 2014. Patients with DMARD use, on average, were younger (aged 67 years ± 10.7 vs. 69 years ± 10.7) and healthier (Deyo-Charlson Comorbidity Index [DCCI] 2.4 ± 1.9 vs. 2.6 ± 2.1) and included a greater proportion of women (75.9% vs. 71.0%) than those with no DMARD use (We found significant differences in demographic and clinical characteristics between patients with and without DMARD use, which can potentially inform treatment decisions regarding DMARD use as deemed necessary by the provider. Future research should investigate the reasons for lack of treatment.This study was supported by funding from Eli Lilly to Humana as a collaborative research project involving employees of both companies. Boytsov, Saverno, Zhang, and Gaich are employees of Eli Lilly. Nair, Bhattacharya, Abbott, and Dixon are employees of Humana, which received funding from Eli Lilly to complete this research. |
| Databáze: | OpenAIRE |
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