BACKGROUND: A variety of biologic therapies are currently used for the treatment of inflammatory autoimmune diseases, including rheumatoid arthritis (RA), psoriasis (PsO), psoriatic arthritis (PsA), and ankylosing spondylitis (AS). These diseases require long-term treatment, and information regarding the use and costs of biologic therapies can be valuable in making treatment and formulary decisions for clinicians and payers.

Heart failure (HF) is currently among the most prevalent and costly chronic diseases among older adults, who are at increased risk because of other chronic conditions and the aging process. HF has a significant impact on the health care system, patient outcomes, and the unsustainable rising costs of care. The primary objectives were to: (1) determine cost savings differences in medical expenditures between engaged and non-engaged members referred to a HF management program; (2) examine differences in length of stay and time to first post-engagement acute inpatient admission; and (3) examine the impact of using a remote weight monitoring scale on medical expenditures and inpatient admissions. Generalized linear modeling was used to compare key outcomes among individuals who engaged in the program and a propensity-matched cohort of those who were eligible but did not engage. Key outcomes included post-engagement acute inpatient medical service utilization, all-cause per-member-per-month medical expenses, and acute inpatient length of stay. When paired with regular use of a remote weight monitoring scale, engagement in this HF management program appears to be associated with decreased risk for acute inpatient admission and lower all-cause medical expenditures. Participation in a clinically based HF management program may improve health-related and financial outcomes among older individuals. However, further development and evaluation of disease management programs could help to improve their effectiveness and thus patient outcomes.

Index date was the date of first IFX claim; 6 months pre-and 12 months post-index were required. Medication Possession Ratio (MPR) was calculated as [total days on IFX therapy based on infusion dates and assumed duration of action/360 days]; at least two infusions were required. MPR thresholds of ≥ 80% and ≥ 60% were used to classify adherent patients. All-cause and CD-related costs per patient per month by place of service were calculated, adjusted to 2011 dollars. Results: A total of 173 patients were identified, 156 of which had at least 2 infusions. Mean age was 47.9 years, 59.5% were female, and 53.8% had Commercial coverage. Across the MPR thresholds, adherent patients had significantly higher all-cause physician office visit costs, and lower other outpatient visit, emergency department and hospitalization costs than non-adherent patients. CD-related costs showed similar trends for physician office visit, other outpatient visit and hospitalization costs. IBD-drug related costs were significantly higher in the adherent group; all-cause pharmacy costs were similar between those adherent and non-adherent. Total CD-related costs were higher among adherent patients (80% MPR, $2532.5(±1439.8) vs. $1949.3(±1395.1), p-value 0.0002), while total all-cause costs were similar between groups (80% MPR, $3236.(±1717.0) vs. $3084.8(±1859.4), p-value 0.2564). ConClusions: Although adherent patients have higher physician office visit and IBD-drug related costs, hospitalization cost was significantly higher for non-adherent patients resulting in similar total all-cause costs for both the adherent and non-adherent groups. Further research should quantify the clinical value of greater adherence against this backdrop of cost neutrality.

Index date was the date of first IFX claim; 6 months pre-and 12 months post-index were required. Medication Possession Ratio (MPR) was calculated as [total days on IFX therapy based on infusion dates and assumed duration of action/360 days]; at least two infusions were required. MPR thresholds of ≥ 80% and ≥ 60% were used to classify adherent patients. All-cause and CD-related costs per patient per month by place of service were calculated, adjusted to 2011 dollars. Results: A total of 173 patients were identified, 156 of which had at least 2 infusions. Mean age was 47.9 years, 59.5% were female, and 53.8% had Commercial coverage. Across the MPR thresholds, adherent patients had significantly higher all-cause physician office visit costs, and lower other outpatient visit, emergency department and hospitalization costs than non-adherent patients. CD-related costs showed similar trends for physician office visit, other outpatient visit and hospitalization costs. IBD-drug related costs were significantly higher in the adherent group; all-cause pharmacy costs were similar between those adherent and non-adherent. Total CD-related costs were higher among adherent patients (80% MPR, $2532.5(±1439.8) vs. $1949.3(±1395.1), p-value 0.0002), while total all-cause costs were similar between groups (80% MPR, $3236.(±1717.0) vs. $3084.8(±1859.4), p-value 0.2564). ConClusions: Although adherent patients have higher physician office visit and IBD-drug related costs, hospitalization cost was significantly higher for non-adherent patients resulting in similar total all-cause costs for both the adherent and non-adherent groups. Further research should quantify the clinical value of greater adherence against this backdrop of cost neutrality.

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