Direct medical costs associated with rheumatoid arthritis in Turkey: analysis from National Claims Database

Abstract

This study aimed to estimate and identify determinants of direct medical costs associated with rheumatoid arthritis (RA) in Turkey using nationwide real-world data. Using the Turkish National Health Insurance Database (2009-2011), RA patients (ages 18-99) were identified using International Classification of Disease Tenth Revision Clinical Modification (ICD-10-CM) codes. Patients were required to have two RA diagnoses at least 60 days apart and were grouped as prevalent and incident cases. The date of the first RA claim was identified for each patient and designated as the index date. Total healthcare costs were examined over the 12-month period following the index date. Descriptive and multivariate analyses are provided. Generalized linear models were used to calculate expected annual costs for incident and prevalent RA patients after controlling for age, gender, region, comorbid conditions and medication. A total of 2,613 patients met all inclusion criteria (693 incident; 1,920 prevalent patients). Prevalent patients were older, less likely to reside in the Marmara region, had higher comorbidity index scores and were more likely to use non-steroidal anti-inflammatory drugs, biologics and disease-modifying anti-rheumatic drugs relative to incident patients. Average direct annual costs were <euro>2,000 [(<euro>1,750, <euro>2,247) 95 % CI] for incident cases and <euro>2,385 [(<euro>2,224, <euro>2,545) 95 % CI] for prevalent cases, most due to pharmacy costs (73 % for incident cases, 60 % for prevalent cases). For incident and prevalent cases, a significant portion of inpatient and outpatient costs were due to physician costs (31 % for incident cases, 40 % for prevalent cases). Although the costs were not significantly different in terms of age or region, prior comorbid conditions and medication use significantly affected the cost estimation. RA total annual costs were found to be lower in Turkey, relative to estimates in Europe. The significant portion of the annual costs was due to pharmaceutical expenditures. Comparative effectiveness analysis may be useful to decrease RA-related pharmacy costs.

A descriptive analysis of real-world treatment patterns of innovator (Remicade^&reg;) and biosimilar infliximab in an infliximab-na&iuml;ve Turkish population

“…27 It is unlikely that patients in this study shouldered any medication cost since patients who had a chronic condition certified by their physician can have their medications fully reimbursed by the Turkish government. 24 Furthermore, the list price for IFX per vial was ₮1,229.49 Turkish Lira and for CT-P13, was ₮1,205.87 Turkish Lira, which represents less than a 2% difference between the products. The lack of a substantial difference between the prices for IFX and CT-P13 in Turkey could be considered a strength of this study and provided an opportunity to gain insight into factors other than price that potentially contribute to observed differences in practice patterns.…”

“…In Turkey, tendering for pharmaceuticals occurs in all public hospitals, 24 and this may, in part, explain the regional variation observed in prescribing and switching practices. Factors, such as disease severity or patient preference for one product over another, unmeasured in this study, may also have contributed to the results observed here.…”

Retrospective analysis of total direct medical costs associated with hepatitis B patients with oral antiviral versus pegylated interferon therapy in Turkey

“…Moreover, members of the Turkish Grand National Assembly and the Supreme Court as well as foreign insurance holders and some military personnel were excluded from the UHI Fund in the SSI. The data have been used in several outcomes research studies .…”

On The Optimization Of Public Procurement Of Medicines For Hospitals

“…In the drug therapy of rheumatoid arthritis, basic anti-inflammatory drugs, genetically engineered biological drugs (limited, due to the high cost of course treatment), glucocorticosteroids, non-steroidal antiinflammatory drugs are used (Arts et al, 2016;Kolbin, Kurylev, Proskurin, & Balykina, 2016). The cost of medical care for patients who have several chronic diseases at the same time (comorbid conditions) significantly exceeds the cost of treating patients who do not have them (Baser, Burkan, Baser, Koselerli, Ertugay, & Altinbas, 2013;Kers, Urozhayeva, & Steffen, 2015).…”