Use of a validated algorithm to estimate the annual cost of effective biologic treatment for rheumatoid arthritis

Curtis, Jeffrey R.; Schabert, Vernon F.; Yeaw, Jason; Korn, Jonathan R.; Quach, Caroleen; Harrison, David J.; Yun, Huifeng; Joseph, George

doi:10.3111/13696998.2014.914031

Cited by 22 publications

(38 citation statements)

References 24 publications

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“…The algorithm used for assessing response did not originally include certolizumab pegol and golimumab. It also has not been validated in the HIRD; however, it has been validated in another similar claims database and used in several others [12, 13, 15, 19]. Patients’ discontinuation was the primary factor in defining treatment nonresponse; however, patients might discontinue a therapy for nonclinical reasons as well, such as financial burden.…”

Section: Discussionmentioning

confidence: 99%

Costs associated with failure to respond to treatment among patients with rheumatoid arthritis initiating TNFi therapy: a retrospective claims analysis

et al. 2017

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Background: Tumor necrosis factor inhibitors (TNFi) are common second-line treatments for rheumatoid arthritis (RA). This study was designed to compare the real-world clinical and economic outcomes between patients with RA who responded to TNFi therapy and those who did not. Methods: For this retrospective cohort analysis we used medical and pharmacy claims from members of 14 large U.S. commercial health plans represented in the HealthCore Integrated Research Database. Adult patients (aged ≥18 years) diagnosed with RA and initiating TNFi therapy (index date) between 1 January 2007 and 30 April 2014 were included in the study. Treatment response was assessed using a previously developed and validated claims-based algorithm. Patients classified as treatment responders in the 12 months postindex were matched 1:1 to nonresponders on important baseline characteristics, including sex, age, index TNFi agent, and comorbidities. The matched cohorts were then compared on their all-cause and RA-related healthcare resource use, and costs were assessed from a payer perspective during the first, second, and third years postindex using parametric tests, regressions, and a nonparametric bootstrap. Results: A total of 7797 patients met the study inclusion criteria, among whom 2337 (30%) were classified as treatment responders. The responders had significantly lower all-cause hospitalizations, emergency department visits, and physical/occupational therapy visits than matched nonresponders during the first-year postindex. Mean total all-cause medical costs were $5737 higher for matched nonresponders, largely driven by outpatient visits and hospitalizations. Mean all-cause pharmacy costs (excluding costs of biologics) were $354 higher for matched nonresponders. Mean RA-related pharmacy costs (conventional synthetic and biologic drugs), however, were $8579 higher in the responder cohort, driven by higher adherence to their index TNFi agent (p < 0.01 for all comparisons). A similar pattern of cost differentiation was observed over years 2 and 3 of follow-up. Conclusions: In this real-world study we found that, compared with matched nonresponders, patients who responded to TNFi treatments had lower all-cause medical, pharmacy, and total costs (excluding biologics) up to 3 years from initiation of TNFi therapy. These cost differences between the two cohorts provide a considerable offset to the cost of RA medications and should encourage close monitoring of treatment response to minimize disease progression with appropriate therapy choices.

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Section: Discussionmentioning

confidence: 99%

Costs associated with failure to respond to treatment among patients with rheumatoid arthritis initiating TNFi therapy: a retrospective claims analysis

et al. 2017

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“…This was a retrospective cohort analysis of patients aged ≥18 years with any diagnosis of RA ( Similar to other analyses, [19][20][21][22][23][24] we defined new starts as patients who were not prescribed a biologic DMARD during the 6-month pre-index period. Patients with another inflammatory disease diagnosis (eg, Crohn's disease, ulcerative colitis, ankylosing spondylitis, psoriasis, systemic lupus erythematosus, overlap connective tissue disease [CTD], mixed CTD, and/or undifferentiated CTD), and those who received >1 biologic DMARD within 14 days were excluded to avoid misclassification of index treatment and switching given that this is not a sufficient trial period for attributing outcomes.…”

Section: Methodsmentioning

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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“…24 Two recently published studies also used the algorithm and managed care databases to examine biologic effectiveness and costs in patients with RA, and the results of those studies were consistent with the findings of this study. 38,39 This analysis examined biologic costs because there is a clear relationship between the cost and the effect of the index biologic, whereas total health care costs include many other costs unrelated to RA or effective biologic treatment. Even when other health care costs are directly related to the effective treatment of RA, it is difficult to establish cause and effect.…”

Section: Percentage Of Patients Meeting Each Algorithm Criterion By Bmentioning

confidence: 99%

Cost and Effectiveness of Biologics for Rheumatoid Arthritis in a Commercially Insured Population

Curtis

Chastek²,

Becker³

et al. 2015

JMCP

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Use of a validated algorithm to estimate the annual cost of effective biologic treatment for rheumatoid arthritis

Cited by 22 publications

References 24 publications

Costs associated with failure to respond to treatment among patients with rheumatoid arthritis initiating TNFi therapy: a retrospective claims analysis

Costs associated with failure to respond to treatment among patients with rheumatoid arthritis initiating TNFi therapy: a retrospective claims analysis

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

Cost and Effectiveness of Biologics for Rheumatoid Arthritis in a Commercially Insured Population

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