Switching of biologic disease modifying anti-rheumatic drugs in patients with rheumatoid arthritis in a real world setting

Meissner, Brian; Trivedi, Digisha; You, Min Su; Rosenblatt, Lisa

doi:10.3111/13696998.2014.893241

Cited by 40 publications

(31 citation statements)

References 12 publications

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“…These results complement a recent US administrative claims data analysis that showed that patients who switched biologic incurred higher costs than patients who did not switch (USD 3,759 vs USD 2,343 per month; P <0.05) 36. Furthermore a recent Swedish study showed that patients who were nonpersistent incurred USD 1,730 higher costs per year compared to persistent patients 37.…”

Section: Discussionsupporting

confidence: 81%

Persistence and costs with subcutaneous TNF-alpha inhibitors in immune-mediated rheumatic disease stratified by treatment line

Svedbom¹,

Dalén²,

Black³

et al. 2017

PPA

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ObjectivesThe objectives of this study were to 1) describe and compare treatment persistence with first- and second-line subcutaneous tumor necrosis factor-alpha inhibitors (SC-TNFis) in patients with ankylosing spondylitis (AS), psoriatic arthritis (PsA), or rheumatoid arthritis (RA) (collectively immune-mediated rheumatic disease) in Sweden and 2) estimate and contrast health care costs in the two groups.MethodsPatients who initiated their first or second SC-TNFi between May 6 2010 and December 12 2012 were identified from the Prescribed Drug Register. Persistence was estimated using survival analysis. Costs comprised specialized outpatient care, inpatient care, and medication. The persistence analysis was stratified by immune-mediated rheumatic disease diagnosis.ResultsA total of 4,903 patients treated with their first and 845 patients treated with their second SC-TNFi were identified. Baseline characteristics differed between the two groups. Therefore, propensity score matching analysis was implemented. Second-line patients were matched to first-line patients, and four cohort pairs (AS, PsA, RA, and all diagnoses combined) were generated. Patients treated with their first SC-TNFi had statistically significant higher persistence than patients treated with their second SC-TNFi in PsA (P=0.036), RA (P=0.048), and all diagnoses combined (P<0.001) but not in AS (P=0.741). Patients who were treated with their second SC-TNFi incurred higher costs than patients treated with their first SC-TNFi.ConclusionOverall, persistence to the first SC-TNFi was higher than persistence to the second SC-TNFi. Furthermore, the second SC-TNFi was associated with higher costs than the first SC-TNFi. Therefore, prescribing the SC-TNFi with the best long-term persistence first may be beneficial.

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Section: Discussionsupporting

confidence: 81%

Persistence and costs with subcutaneous TNF-alpha inhibitors in immune-mediated rheumatic disease stratified by treatment line

Svedbom¹,

Dalén²,

Black³

et al. 2017

PPA

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“…Although therapy switch in DMARD users has been shown to be frequent (Meissner et al. ; Jørgensen et al. ), the treatment regimen (switch, concurrent use) could not be assessed due to the cross‐sectional study design per calendar year.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, direct linkage between prescriptions and diagnoses of possible indications is not possible. Although therapy switch in DMARD users has been shown to be frequent (Meissner et al 2014;Jørgensen et al 2015), the treatment regimen (switch, concurrent use) could not be assessed due to the cross-sectional study design per calendar year.…”

Section: Discussionmentioning

confidence: 99%

Frequency and trends of disease‐modifying antirheumatic drug (DMARD) use in Germany

Fassmer

Garbe

Schmedt

2016

Pharmacology Res & Perspec

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The aim of this study was to analyze the population‐based frequency of classic (c‐) and biologic (b‐) disease‐modifying antirheumatic drug (DMARD) use over time, selected underlying indications and the specialty of the prescribing physicians in Germany. Based on the claims data of the German Pharmacoepidemiological Research Database (GePaRD), yearly cross‐sectional studies were conducted from 2004 to 2011. The prevalence of DMARD use was calculated as the number of persons with at least one dispensation per 1000 persons stratified by sex and age. In 2011, we also obtained the proportion of c‐ and b‐DMARDs users with diagnoses of selected indications and the proportion of dispensations by specialty of the physician. Between 2004 and 2011, the annual prevalence of b‐DMARD and c‐DMARD use increased from 0.35‰ to 1.54‰ and from 6.53‰ to 8.93‰, respectively. In 2011, the study population comprised 12.8 million insurants with a mean age of 44.0 years. During this year, among c‐DMARDs, methotrexate was prescribed most frequently (4.76‰), followed by azathioprine (1.72‰) and sulfasalazine (1.20‰). For b‐DMARDs, adalimumab (0.57‰), etanercept (0.46‰), and rituximab (0.23‰) were most frequently used. Notably, b‐DMARD users more often had a diagnosis of ankylosing spondylitis and psoriasis compared to c‐DMARD‐users (20.7% vs. 2.9% and 20.0% vs. 11.4%, respectively) and b‐DMARDs were more frequently prescribed by rheumatologists and other specialists. Our population‐based study highlights the increasing use of c‐ and b‐DMARDs in Germany. Compared to c‐DMARDs, b‐DMARDs were commonly used for indications besides rheumatoid arthritis. Future research should therefore also focus on their prescription patterns and safety aspects in indications other than RA.

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“…Furthermore, monthly total healthcare costs have been shown to be higher for patients with RA who switch therapy than those who do not, and higher again for a second or third switch. 18 Here, we aim to provide an evaluation of treatment patterns, associated healthcare resource use (HCRU), and costs for patients with RA in the 12-month period following TNFi treatment initiation. In addition, we further examine overall TNFi treatment cycling patterns, HCRU, and costs in the 12month period following switch from index TNFi to another biologic DMARD (alternative TNFi or a non-TNFi biologic DMARD).…”

Section: Introductionmentioning

confidence: 99%

Real-world evaluation of TNF-inhibitor utilization in rheumatoid arthritis

Harnett

Wiederkehr

Gerber

et al. 2015

Journal of Medical Economics

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Switching of biologic disease modifying anti-rheumatic drugs in patients with rheumatoid arthritis in a real world setting

Cited by 40 publications

References 12 publications

Persistence and costs with subcutaneous TNF-alpha inhibitors in immune-mediated rheumatic disease stratified by treatment line

Persistence and costs with subcutaneous TNF-alpha inhibitors in immune-mediated rheumatic disease stratified by treatment line

Frequency and trends of disease‐modifying antirheumatic drug (DMARD) use in Germany

Real-world evaluation of TNF-inhibitor utilization in rheumatoid arthritis

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