Assessment of patients affected by rheumatoid arthritis eligible for biotechnological agents and evaluation of their healthcare resource utilization and related costs
| Autor: | Vittorio Perrone, Luigi Sinigaglia, L. Degli Esposti, Diego Sangiorgi |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
rheumatoid arthritis
real-world medicine.medical_specialty medicine.drug_class Biotechnological therapy Arthritis Rheumatoid 03 medical and health sciences Indirect costs 0302 clinical medicine Rheumatology Internal medicine Health care medicine Humans 030212 general & internal medicine 030203 arthritis & rheumatology business.industry medicine.disease RC31-1245 Methotrexate Treatment Outcome Lung disease under-treatment Rheumatoid arthritis Antirheumatic Agents Medicine Corticosteroid Drug Therapy Combination Antirheumatic drugs business Delivery of Health Care Resource utilization medicine.drug |
| Zdroj: | Reumatismo, Vol 73, Iss 1 (2021) |
| ISSN: | 0048-7449 |
| Popis: | Objective. To provide estimates of patients with rheumatoid arthritis (RA) eligible for biotechnological therapy and to evaluate their healthcare costs. Method. An observational analysis was performed based on data-linkage between administrative databases of selected Italian Regional/Local healthcare departments. Data were then re-proportioned to the Italian population. Patients with RA diagnosis defined by discharge diagnosis and/or exemption code during 01/01/2013- 31/12/2017 were included. The criteria applied to evaluate the elegibility for biotechnological therapy were: 1) methotrexate (MTX)-treatment failure ≥6 months and start of a different conventional-synthetic diseasemodifying antirheumatic drugs (csDMARD); 2) corticosteroid ≥6 months with dosage ≥7.5 mg/die; 3) MTX-contraindication (therapy or hospitalization for renal damage/interstizial lung disease/hepatic failure). Mean annual costs per patient included drugs, hospitalizations, outpatient services. Results. Data re-proportioned to the Italian population estimated 318,328 RA patients: 43,361 with, 274,967 without biotechnological agents. Among the latter, 26,487(9.6%) patients met ≥1 criteria applied for eligibility: 1,896 had MTX-treatment failure and started another csDMARD; 15,833 received corticosteroid ≥7.5 mg/die; 7,788 had MTX-contraindication. Regarding patients fulfilling two criteria, 107 had MTX-treatment failure followed by another csDMARDs and corticosteroid ≥7.5 mg/die, 53 were treated with another csDMARDs after MTX-treatment failure and also presented MTX-contraindication, 810 had corticosteroid ≥7.5 mg/die and MTX-contraindication. Mean total annual costs for patients estimated eligible for biotechnological therapy was € 3,132, of which € 177 related to drugs indicated for RA and € 2,955 related to other direct costs. Conclusions. According to our estimates, around 10% RA patients not currently treated with biotechnological agents are eligible for such therapies, highlighting a trend of under-use in clinical practice for RA management. |
| Databáze: | OpenAIRE |
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