Adherence, Discontinuation, and Switching of Biologic Therapies in Medicaid Enrollees with Rheumatoid Arthritis

Li, Pengxiang; Blum, Marissa; Feldt, Joan Von; Hennessy, Sean; Doshi, Jalpa A.

doi:10.1111/j.1524-4733.2010.00764.x

Cited by 79 publications

(63 citation statements)

References 20 publications

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“…Demographic (age and gender distribution) and clinical characteristics of the final matched study sample were found to be consistent with those reported by other studies of patients with RA that were conducted using retrospective database analysis. 2,4,[28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] However, in contrast to other studies where the majority of participants were white, the present study had a majority Hispanic population (53.7%). 31,32,36,37 This was expected, since Hispanics have been reported to account for a significant proportion (≈ 40%) of the Texas population.…”

Section: Medication Effectiveness With the Use Of Tumor Necrosis Factcontrasting

confidence: 42%

“…Adherence seen in this study was lower than has been reported in previous adherence studies that also used administrative claims data (commercial or Medicaid). 2,30,31,36 This may be because of the high Hispanic population (53.7%) in the study sample. Being of an ethnic minority has been associated with poor medication adherence.…”

Section: Medication Effectiveness With the Use Of Tumor Necrosis Factmentioning

confidence: 91%

“…The direction of study results was comparable with those of earlier studies regardless of the method used for estimating adherence. 2,31,33,36 Differences in adherence may be a function of the route and frequency of administration. 4 IFX is administered intravenously at the physician's office by a health care provider, while ETN and ADA are administered subcutaneously by the patient.…”

Section: Limitationsmentioning

confidence: 99%

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Medication Effectiveness with the Use of Tumor Necrosis Factor Inhibitors Among Texas Medicaid Patients Diagnosed with Rheumatoid Arthritis

Oladapo

Barner²,

Lawson³

et al. 2014

JMCP

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While their effectiveness has not been directly compared in a clinical trial, results from the majority of the indirect treatment comparisons suggest comparable efficacy and safety profiles. However, these TNF inhibitor agents differ in administration method and dosing flexibility, which may result in differences in medication use profiles (e.g., adherence, persistence, discontinuation, dose escalation, and switching to a new biologic rheumatoid arthritis drug) and effectiveness in clinical practice.

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Section: Medication Effectiveness With the Use Of Tumor Necrosis Factcontrasting

confidence: 42%

Section: Medication Effectiveness With the Use Of Tumor Necrosis Factmentioning

confidence: 91%

Section: Limitationsmentioning

confidence: 99%

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Medication Effectiveness with the Use of Tumor Necrosis Factor Inhibitors Among Texas Medicaid Patients Diagnosed with Rheumatoid Arthritis

Oladapo

Barner²,

Lawson³

et al. 2014

JMCP

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“…A taxa de não adesão à terapia biológica verificada neste estudo foi alta; um terço dos pacientes não aderiu ao tratamento no primeiro ano. Comparando-se os resultados de outros estudos que também utilizaram dados administrativos, as taxas de não adesão variaram entre 25% e 68% 6,11,12,13,23 . Contudo, avaliaram apenas pacientes portadores de artrite reumatoide.…”

Section: Discussionunclassified

“…Em uma revisão sistemática que incluiu estudos com pacientes em uso de biológicos anti-TNF para o tratamento da artrite reumatoide 24 , foi encontrada uma taxa semelhante de não adesão, ou seja, de um terço. O estudo de Li et al 11 foi o que encontrou maior taxa de não adesão em pacientes portadores de artrite reumatoide, sendo de 68% para o etanercepte. Os autores sugerem que o fato pode estar relacionado com a característica da população estudada, que era de baixo poder aquisitivo.…”

Section: Discussionunclassified

Não adesão à terapia biológica em pacientes com doenças reumáticas no Sistema Único de Saúde em Minas Gerais, Brasil

2015

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Resumo Neste estudo, buscou-se estimar e analisar fatores associados à não adesão ao tratamento com os medicamentos biológicos adalimumabe e etanercepte em pacientes portadores de doenças reumáticas atendidos pelo Sistema Único de Saúde de Minas Gerais, Brasil. Procedeu-se a estudo prospectivo não concorrente com base no registro de dispensação nas farmácias de pacientes adultos em início de tratamento. A taxa de não adesão foi estimada com utilização do método de proporção de dias cobertos (PDC), sendo considerados não aderentes pacientes com PDC < 0,8. Foram identificados 1.150 pacientes, sendo 64,3% portadores de artrite reumatoide, 8,5% de artrite psoriásica e 27,2% de espondilite anquilosante. A taxa de não adesão encontrada foi de 33,5% e os fatores associados foram idade entre 19-39 anos, sexo feminino, diagnóstico de artrite reumatoide e início de tratamento com etanercepte. Os resultados indicam uma alta taxa de não adesão ao tratamento, que pode originar piores resultados em saúde e implicar o aumento da utilização de cuidados e dos custos em saúde.

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Medication Nonadherence Is Associated With Increased Subsequent Acute Care Utilization Among Medicaid Beneficiaries With Systemic Lupus Erythematosus

Feldman

Yazdany

Guan

et al. 2015

Arthritis Care & Research

107

104

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Objective We examined whether nonadherence to hydroxychloroquine (HCQ) or immunosuppressive medications (IS) was associated with higher subsequent acute care utilization among Medicaid beneficiaries with systemic lupus erythematosus (SLE). Methods We utilized U.S. Medicaid data from 2000–2006 to identify adults 18–64 years with SLE who were new users of HCQ or IS. We defined the index date as receipt of HCQ or IS without use in the prior six months. We measured adherence using the medication possession ratio (MPR), the proportion of days covered by total days supply dispensed, for one-year post-index date. Our outcomes were all-cause and SLE-related emergency department (ED) visits and hospitalizations in the subsequent year. We used multivariable Poisson regression models to examine the association between nonadherence (MPR<80%) and acute care utilization adjusting for sociodemographics and comorbidities. Results We identified 9,600 HCQ new users and 3,829 IS new users with SLE. The mean MPR for HCQ was 47.8% (SD 30.3) and for IS, 42.7% (SD 30.7). 79% of HCQ users and 83% of IS users were nonadherent (MPR<80%). In multivariable models, among HCQ users, the incidence rate ratio (IRR) of ED visits was 1.55 (95% CI 1.43–1.69) and the IRR of hospitalizations was 1.37 (95% CI 1.25–1.50), comparing nonadherers to adherers. For IS users, the IRR of ED visits was 1.64 (95% CI 1.42–1.89) and of hospitalizations was 1.67 (95% CI 1.41–1.96) for nonadherers versus adherers. Conclusion In this cohort, nonadherence to HCQ and IS was common and was associated with significantly higher subsequent acute care utilization.

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Adherence, Discontinuation, and Switching of Biologic Therapies in Medicaid Enrollees with Rheumatoid Arthritis

Abstract: This study highlights the poor adherence to and premature discontinuation without concurrent switching of RA biologics that should raise concern for clinicians as well as payers.

Cited by 79 publications

References 20 publications

Medication Effectiveness with the Use of Tumor Necrosis Factor Inhibitors Among Texas Medicaid Patients Diagnosed with Rheumatoid Arthritis

Medication Effectiveness with the Use of Tumor Necrosis Factor Inhibitors Among Texas Medicaid Patients Diagnosed with Rheumatoid Arthritis

Não adesão à terapia biológica em pacientes com doenças reumáticas no Sistema Único de Saúde em Minas Gerais, Brasil

Medication Nonadherence Is Associated With Increased Subsequent Acute Care Utilization Among Medicaid Beneficiaries With Systemic Lupus Erythematosus

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