Three years experience with the prescription of anti‐TNF‐α inhibitors at Dr Soliman Fakeeh Hospital in Jeddah, Saudi Arabia

Abstract

Objective: To document the difficulties that are associated with the prescription of anti-TNF inhibitors due to their high cost for patients with various autoimmune rheumatic diseases in the Kingdom of Saudi Arabia. Methods:Patients who had been prescribed anti-TNF inhibitors for the treatment of autoimmune rheumatic diseases at Dr. Soliman Fakeeh Hospital in the Kingdom of Saudi Arabia from 2005 to July 2008 were retrospectively included in this study. Data collected included patients' demographics, funding methods, treatment doses and assessment results.Results: Thirty-six patients were included in this study. Seventy percent of these were covered by various insurance packages while 30% were paying cash for their treatment. Of those 36 patients, seven dropped out within the first 2 months of treatment. Thereafter, a gradually increasing number of patients either discontinued treatment or were no longer compliant with their scheduled injection dates. There was a statistically highly significant correlation between financial difficulties and discontinuing treatment and/or spacing-out the administration of anti-TNF agents (P < 0.001). On the other hand, neither safety nor efficacy profiles were shown to significantly impact drug discontinuation. The impact of financial difficulties tended to be more prominent during the first 6 months of treatment. Conclusion:Financial issues appear to be the major factor that is interfering with the compliance with treatment with anti-TNF agents in the Kingdom of Saudi Arabia. The anti-TNF agents studied were generally well tolerated and were effective.

<p>Clinicodemographic Profiles of Rheumatoid Arthritis Patients from a Single Center in Saudi Arabia</p>

“…Patients in private, insurancebased hospitals have the privilege to access biological treatments more easily and yet, financial issues appear to be a major factor that can interfere with biological treatment compliance in private Saudi hospitals for those not covered by insurance. 18 Regarding the correlation of the disease activity using the DAS28-CRP with the medications used to treat our patients, 51% of the patients on csDMARDs had moderate disease activity, whereas those on biological treatment had a 42% remission rate. Similarly, data from the DANBIO registry in Denmark showed that patients on anti-tumor necrosis factor alpha (anti-TNFα) had higher remission rates compared to csDMARDs alone.…”

Tumour necrosis factor inhibitors and risk of serious infection in rheumatoid arthritis

“…These recommendations are now also being applied in APLAR countries such as the Phillipines 64 . However, the costs of screening and treatment of latent TB is likely to further increase the cost of these drugs in these countries where at times access is already limited by cost 65 . Since these screening guidelines have been implemented it may be that the infection profile with TNF inhibitors has changed.…”

Rilonacept in the management of cryopyrin-associated periodic syndromes (CAPS)

“…Regular follow-ups over the course of 3 years found 52% of patients (19 of 36) had discontinued treatment due to financial reasons while 8% of patients (3 of 36) continued but treatment was suboptimal with spaced out regimes. 44 This study is representative of a global issue. Anakinra, an off label treatment with clinical efficacy in CAPS, is associated with an approximate monthly cost (based on average wholesale price) of uS$1515 and rilonacept, the FDA approved treatment for CAPS, has an approximate average monthly cost of uS$30,000.…”