Drug usage analysis and health care resources consumption in naïve patients with rheumatoid arthritis

Drug usage analysis and health care resources consumption in naïve patients with rheumatoid arthritis

Diego Sangiorgi,1 Maurizio Benucci,2 Carmela Nappi,3 Valentina Perrone,1 Stefano Buda,1 Luca Degli Esposti11CliCon S.r.l., Health, Economics and Outcomes Research, Ravenna, 2Unit of Rheumatology, S. Giovanni di Dio Hospital, Florence, 3Bristol Myers Squibb S.r.l., Rome, ItalyObjectives: The use of b...

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Autores principales: Sangiorgi D, Benucci M, Nappi C, Perrone V, Buda S, Degli Esposti L
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Lenguaje:EN
Publicado: Dove Medical Press 2015
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Medicine (General)
R5-920
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spelling oai:doaj.org-article:22d84e2095cf45ce88788f65d785f0932021-12-02T00:51:37ZDrug usage analysis and health care resources consumption in naïve patients with rheumatoid arthritis1177-5491https://doaj.org/article/22d84e2095cf45ce88788f65d785f0932015-11-01T00:00:00Zhttps://www.dovepress.com/drug-usage-analysis-and-health-care-resources-consumption-in-naiumlve--peer-reviewed-article-BTThttps://doaj.org/toc/1177-5491Diego Sangiorgi,1 Maurizio Benucci,2 Carmela Nappi,3 Valentina Perrone,1 Stefano Buda,1 Luca Degli Esposti11CliCon S.r.l., Health, Economics and Outcomes Research, Ravenna, 2Unit of Rheumatology, S. Giovanni di Dio Hospital, Florence, 3Bristol Myers Squibb S.r.l., Rome, ItalyObjectives: The use of biologic agents has revolutionized the management of rheumatoid arthritis (RA) in the past 2 decades. These biologic agents directly target molecules and cells involved in the pathogenesis of RA. The purpose of this study was to assess the usage of biologic agents in terms of persistence to treatment, dose escalation, and consumption of health care resources (hospitalizations, drugs, and outpatients service) in the real clinical practice in naïve patients with RA.Methods: We conducted a real-world, retrospective, observational cohort study based on data obtained from administrative databases of three Local Health Units in Italy. The population included adults diagnosed with RA who had at least one prescription between January 1, 2009 and December 31, 2011, for a biologic that was approved for treatment of RA. The patients were followed for 12 months after enrollment. The clinical characteristics of the patients enrolled in this study were also investigated in the 1-year period before the index date. The main and secondary endpoints were evaluated only in biologic-naïve patients without switches. The overall health care costs for patients were evaluated.Results: A total of 594 patients met the study criteria (mean age 53.5±13.5, female:male ratio =3:1). Thirty-nine percent received etanercept, 25% adalimumab, 14% infliximab, 10% abatacept, 9% tocilizumab, and 3% golimumab. After 1 year of observation, patients showed similar use of other RA-related medication. For the naïve patients without switches, the persistence levels were: 78% for etanercept, 72% for tocilizumab, 71% for adalimumab, 69% for infliximab, and 64% for abatacept. For all agents, dose escalation was 21.4% for infliximab, 11.5% for adalimumab, 5.6% for abatacept, 4% for tocilizumab, and 3.8% for etanercept. The annual costs per treated patients were €12,803 for adalimumab, €11,924 for etanercept, €11,830 for tocilizumab, €11,201 for infliximab, and €10,943 for abatacept.Conclusion: The role of biologic therapies in the treatment of RA continues to evolve; our study reflects real-world drug utilization data in adult patients with RA. These observations could be used by decision makers to support formulary decisions, although further research is needed using a larger sample to validate these results.Keywords: rheumatoid arthritis, biologic agents, real-world dataSangiorgi DBenucci MNappi CPerrone VBuda SDegli Esposti LDove Medical PressarticleMedicine (General)R5-920ENBiologics: Targets & Therapy, Vol 2015, Iss default, Pp 119-127 (2015)
institution DOAJ
collection DOAJ
language EN
topic Medicine (General)
R5-920
spellingShingle Medicine (General)
R5-920
Sangiorgi D
Benucci M
Nappi C
Perrone V
Buda S
Degli Esposti L
Drug usage analysis and health care resources consumption in naïve patients with rheumatoid arthritis
description Diego Sangiorgi,1 Maurizio Benucci,2 Carmela Nappi,3 Valentina Perrone,1 Stefano Buda,1 Luca Degli Esposti11CliCon S.r.l., Health, Economics and Outcomes Research, Ravenna, 2Unit of Rheumatology, S. Giovanni di Dio Hospital, Florence, 3Bristol Myers Squibb S.r.l., Rome, ItalyObjectives: The use of biologic agents has revolutionized the management of rheumatoid arthritis (RA) in the past 2 decades. These biologic agents directly target molecules and cells involved in the pathogenesis of RA. The purpose of this study was to assess the usage of biologic agents in terms of persistence to treatment, dose escalation, and consumption of health care resources (hospitalizations, drugs, and outpatients service) in the real clinical practice in naïve patients with RA.Methods: We conducted a real-world, retrospective, observational cohort study based on data obtained from administrative databases of three Local Health Units in Italy. The population included adults diagnosed with RA who had at least one prescription between January 1, 2009 and December 31, 2011, for a biologic that was approved for treatment of RA. The patients were followed for 12 months after enrollment. The clinical characteristics of the patients enrolled in this study were also investigated in the 1-year period before the index date. The main and secondary endpoints were evaluated only in biologic-naïve patients without switches. The overall health care costs for patients were evaluated.Results: A total of 594 patients met the study criteria (mean age 53.5±13.5, female:male ratio =3:1). Thirty-nine percent received etanercept, 25% adalimumab, 14% infliximab, 10% abatacept, 9% tocilizumab, and 3% golimumab. After 1 year of observation, patients showed similar use of other RA-related medication. For the naïve patients without switches, the persistence levels were: 78% for etanercept, 72% for tocilizumab, 71% for adalimumab, 69% for infliximab, and 64% for abatacept. For all agents, dose escalation was 21.4% for infliximab, 11.5% for adalimumab, 5.6% for abatacept, 4% for tocilizumab, and 3.8% for etanercept. The annual costs per treated patients were €12,803 for adalimumab, €11,924 for etanercept, €11,830 for tocilizumab, €11,201 for infliximab, and €10,943 for abatacept.Conclusion: The role of biologic therapies in the treatment of RA continues to evolve; our study reflects real-world drug utilization data in adult patients with RA. These observations could be used by decision makers to support formulary decisions, although further research is needed using a larger sample to validate these results.Keywords: rheumatoid arthritis, biologic agents, real-world data
format article
author Sangiorgi D
Benucci M
Nappi C
Perrone V
Buda S
Degli Esposti L
author_facet Sangiorgi D
Benucci M
Nappi C
Perrone V
Buda S
Degli Esposti L
author_sort Sangiorgi D
title Drug usage analysis and health care resources consumption in naïve patients with rheumatoid arthritis
title_short Drug usage analysis and health care resources consumption in naïve patients with rheumatoid arthritis
title_full Drug usage analysis and health care resources consumption in naïve patients with rheumatoid arthritis
title_fullStr Drug usage analysis and health care resources consumption in naïve patients with rheumatoid arthritis
title_full_unstemmed Drug usage analysis and health care resources consumption in naïve patients with rheumatoid arthritis
title_sort drug usage analysis and health care resources consumption in naïve patients with rheumatoid arthritis
publisher Dove Medical Press
publishDate 2015
url https://doaj.org/article/22d84e2095cf45ce88788f65d785f093
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