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Economic impact of biologic utilization patterns in patients with psoriatic arthritis.
- Source :
-
Clinical rheumatology [Clin Rheumatol] 2017 Jul; Vol. 36 (7), pp. 1579-1588. Date of Electronic Publication: 2017 May 04. - Publication Year :
- 2017
-
Abstract
- The aim of the study is to examine the frequency and costs associated with above-label dosing of biologics in patients with psoriatic arthritis (PsA). MarketScan identified adults with ≥1 International Classification of Diseases, Clinical Modification diagnosis for PsA and ≥1 pharmacy claim for biologics of interest between January 1, 2011 and December 31, 2013. The first biologic claim was the index date with a 1-year follow-up period and three additional months to confirm continuous biologic use. Exclusion criteria included switching to a different biologic or diagnosis with another autoimmune disease. During the follow-up period, duration was stratified into three groups: <30, 30-179, and ≥180 days of above-label dosing (>10% of the labeled dose). One-tailed t test was conducted to examine the impact of above-label duration on healthcare costs. We identified 4245 PsA patients receiving etanercept (n = 2342), adalimumab (n = 1788), and golimumab (n = 115). Above-label dosing of <30 days (85% adalimumab, 90.4% etanercept, and 95.7% golimumab) and ≥180 days (9.6% adalimumab, 4.1% etanercept, and 2.6% golimumab) was observed. All-cause total healthcare costs for <30 days of above-label use (etanercept $30,625, adalimumab $31,620, and golimumab $37,224), 30-179 days (etanercept $35,602, adalimumab $38,915, and golimumab $64,349), and ≥180 days (etanercept $55,349, adalimumab $54,176, and golimumab $47,993) were reported. Longer above-label duration (30-179 versus <30 days, ≥180 versus 30-179 and ≥180 days) with etanercept or adalimumab was significantly associated with higher mean increased total all-cause healthcare, PsA-specific healthcare, and biologic costs (p < 0.05). Above-label use of anti-TNF biologics does occur and is associated with significantly increased healthcare costs.
- Subjects :
- Adalimumab economics
Adalimumab therapeutic use
Antibodies, Monoclonal economics
Antibodies, Monoclonal therapeutic use
Antirheumatic Agents economics
Arthritis, Psoriatic diagnosis
Arthritis, Psoriatic economics
Biological Products economics
Dose-Response Relationship, Drug
Etanercept economics
Etanercept therapeutic use
Humans
Retrospective Studies
Severity of Illness Index
Treatment Outcome
Antirheumatic Agents therapeutic use
Arthritis, Psoriatic drug therapy
Biological Products therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1434-9949
- Volume :
- 36
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Clinical rheumatology
- Publication Type :
- Academic Journal
- Accession number :
- 28474139
- Full Text :
- https://doi.org/10.1007/s10067-017-3636-3