Currently Viewing:
The American Journal of Managed Care Special Issue: Pharmacy Benefits
A Gray Area for Reimbursement: Medical Foods for Non–Inborn Errors of Metabolism
Leslie Wilson, PhD; Tracy Kuo Lin, MSc, PhD; Anna Oh, RN, MPH; and Vicky Cao, PharmD
Disease-Modifying Antirheumatic Drug Initiation Among Patients Newly Diagnosed With Rheumatoid Arthritis
Machaon Bonafede, PhD, MPH; Barbara H. Johnson, MBA; Neel Shah, PhD, BPharm; David J. Harrison, PhD; Derek Tang, PhD, BSPharm; and Bradley S. Stolshek, PharmD
Cost Per Response Analysis of Strategies for Chronic Immune Thrombocytopenia
Kelly Fust, MS; Anju Parthan, PhD; Xiaoyan Li, PhD; Anjali Sharma, MD; Xinke Zhang, MS; Marco Campioni, PhD; Junji Lin, PhD, MS; Xuena Wang, PhD; Richard Zur, PhD; Karynsa Cetin, MPH; Melissa Eisen, MD; and David Chandler, PhD
Costs Associated With Long-Acting Insulin Analogues in Patients With Diabetes
Berhanu Alemayehu, DrPH, MS; Jessica Speiser, MPH; Lisa Bloudek, PharmD, MS; and Evelyn Sarnes, PharmD, MPH
5-ASA to Sulfasalazine Drug Switch Program in Patients With Ulcerative Colitis
Jason R. Goldsmith, MD, PhD; Akbar K. Waljee, MD; Tom George, PharmD; Alexandra Brown, BS; Hae Mi Choe, PharmD; Mohamed Noureldin, MBBS; Steven J. Bernstein, MD, MPH; and Peter D.R. Higgins, MD, PhD
Direct Oral Anticoagulant Prescription Trends, Switching Patterns, and Adherence in Texas Medicaid
Shui Ling Wong, MS; Landon Z. Marshall, PharmD; and Kenneth A. Lawson, PhD
Currently Reading
Two-Year Adherence and Costs for Biologic Therapy for Rheumatoid Arthritis
Bradley S. Stolshek, PharmD; Sally Wade, MPH; Alex Mutebi, PhD, MSc; Ajita P. De, MA, MPhil, MS; Rolin L. Wade, MS; and Jason Yeaw, MPH
Impact of Medical and/or Pharmacy Reimbursement on Adult Vaccination Rates
Gaurav Deshpande, PhD, MS; Jay Visaria, PhD, MPH; Joseph Singer, MD; and Kelly D. Johnson, PhD, MPH
Treatment Patterns Among Adults With ADHD Receiving Long-Acting Therapy
Zhou Zhou, MS; Zheng-Yi Zhou, PhD; Sneha S. Kellar, MPH; Vanja Sikirica, PharmD, MPH; Jipan Xie, MD, PhD; and Regina Grebla, PhD
Modeling the Impacts of Restrictive Formularies on Patients With HIV
James Baumgardner, PhD; Caroline Huber, MPH; Mina Kabiri, PhD; Lara Yoon, MPH; Jacki Chou, MPP, MPL; and John Romley, PhD

Two-Year Adherence and Costs for Biologic Therapy for Rheumatoid Arthritis

Bradley S. Stolshek, PharmD; Sally Wade, MPH; Alex Mutebi, PhD, MSc; Ajita P. De, MA, MPhil, MS; Rolin L. Wade, MS; and Jason Yeaw, MPH
Adherence to newly initiated biologic therapy for rheumatoid arthritis is important for long-term adherence.

Objectives: To evaluate adherence to newly initiated biologic disease-modifying antirheumatic drugs (bDMARDs) in effectively treated patients with rheumatoid arthritis (RA).

Study Design: Retrospective cohort study of administrative claims data (IMS PharMetrics Plus) for services incurred from July 1, 2008, to December 31, 2014.

Methods: Data from patients with RA aged 18 to 64 years with continuous enrollment for at least 30 months and initiating abatacept, adalimumab, certolizumab pegol, etanercept, golimumab, or infliximab were analyzed. Treatment effectiveness was determined using a validated algorithm. Outcomes included adherence rates (proportion of days covered ≥80%) for 1 year and 2 years, year 2 adherence among patients effectively and noneffectively treated in year 1, year 2 adherence predictors, and year 2 costs and cost predictors.

Results: Across 10,374 patients, adherence rates were 46% for year 1 and 34% for 2 years; rates were lowest for golimumab and highest for infliximab. In year 1, 3076 (29.7%) patients were considered effectively treated. Year 2 adherence was 59% in effectively treated patients, 32% in patients who failed any effectiveness criteria, and 12% in patients who failed only the adherence criterion. Intravenous bDMARDs, older age, male sex, Northeast region, commercial payer, prior DMARD use, index year 2010 or later, and lower preindex all-cause costs each predicted better adherence. Adjusted year 2 all-cause and RA-related costs were $39,425 and $22,123, respectively, for effectively treated patients and $25,313 and $9250 for noneffectively treated patients. Cost predictors included effective treatment, region, payer, and index year.

Conclusions: Adherence to the first bDMARD was suboptimal even in effectively treated patients, suggesting opportunities to improve adherence in patients with RA initiating biologics.

Am J Manag Care. 2018;24(Spec Issue No. 8):SP315-SP321

Become a Member to see the rest of this article and get access to all of our articles and resources. Membership is Free!

Copyright AJMC 2006-2018 Clinical Care Targeted Communications Group, LLC. All Rights Reserved.
Welcome the the new and improved, the premier managed market network. Tell us about yourself so that we can serve you better.
Sign Up

Sign In

Not a member? Sign up now!