Treatment patterns and annual biologic costs in US veterans with rheumatic conditions or psoriasis

Abstract

Infliximab has higher cost to the VHA than adalimumab or etanercept.

Medication adherence and persistence in patients with rheumatoid arthritis, psoriasis, and psoriatic arthritis: a systematic literature review

“…The sample sizes of the included studies vary widely, ranging from 45 patients 35 to 15,834 patients, 41 with most including more than 100 patients. Adherence and/or persistence in RA was examined in 26 studies, 21 – 32 , 41 PsO in 12 studies, 34 – 40 , 42 , 44 , 55 – 57 and PsA in five studies. 32 , 41 , 42 , 58 , 59 A few studies evaluated a mixed group of patients or data in more than one of the disease states of interest.…”

“…A total of 23 studies evaluated medication persistence rates in RA (17 studies), PsO (six studies), and PsA (four studies) patient populations, with four studies 41 , 42 , 44 , 54 evaluating more than one disease state for their patient population. Persistence was defined variably across studies ( Table 2 ).…”

“…Using the criteria of a gap of ≥45 days over a 1-year time period, the median persistence rate was 61% (range, 46%–89%) from four studies that evaluated etanercept. 42 – 45 For adalimumab and infliximab, the median rates were 57.5% (range, 42%–94%) and 63% (range, 41%–76%), respectively. 42 – 45 Abatacept and golimumab rates were reported in three studies, 42 – 44 with median rates of 52% (range, 41%–62%) and 29.5% (range, 20%–55%), respectively.…”

The use of natural language processing on narrative medication schedules to compute average weekly dose

“…In our initial research on veterans with rheumatoid arthritis, we wanted to study whether escalating the dose of biologic Disease Modifying Antirheumatic Drugs (DMARDs) was effective compared with strategies that involved switching medications . In pharmacoepidemiological research, investigators often use unit strength, dispensed quantity, and days of supply to estimate the prescribed daily or weekly dose.…”

“…In our initial research on veterans with rheumatoid arthritis, we wanted to study whether escalating the dose of biologic Disease Modifying Antirheumatic Drugs (DMARDs) was effective compared with strategies that involved switching medications. 1,2 In pharmacoepidemiological research, investigators often use unit strength, dispensed quantity, and days of supply to estimate the prescribed daily or weekly dose. This approach, however, is unreliable for biologic DMARDs subcutaneously administered at home and for medications with complex weekly dosing schedules, such as methotrexate, because of known inconsistencies in Veterans Health Affairs (VHA) Corporate Data Warehouse (CDW) pharmacy dispensing data.…”