Document Detail


Dosing patterns and costs of tumor necrosis factor inhibitor use for rheumatoid arthritis.
MedLine Citation:
PMID:  20651319     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
PURPOSE: Differences in dosing patterns and costs among patients with rheumatoid arthritis (RA) treated with the tumor necrosis factor (TNF) inhibitors etanercept, adalimumab, and infliximab were analyzed on the basis of claims data. METHODS: Commercial health insurance claims data from January 2004 through December 2005 from the PharMetrics Patient-centric Database were analyzed. Adults (> or =18 years of age) with RA with a minimum of two claims for the same TNF inhibitor within a 12-month period and with at least 18 months of continuous enrollment in the database (encompassing a 6-month preindex period and a 12-month follow-up period) were included. Patients were considered treatment naive if they had no claims for a TNF inhibitor during the preindex period; continuing patients had at least one TNF-inhibitor claim during the preindex period. RESULTS: A total of 845 treatment-naive and 3783 continuing patients were included. Medication use, costs, and health care use were generally similar among the treatment groups in the preindex period for both naive and continuing patients. Among both naive and continuing patients, dose increases from the first to the last prescription were most likely to occur in the infliximab group (26% and 24%, respectively) compared with the adalimumab (10% and 9%) and etanercept (1% and 3%) groups. Etanercept was associated with the lowest and infliximab with the highest total anti-TNF therapy costs. Anti-TNF-related costs were higher among patients with a high index dose, a dose increase, or both during the follow-up period than among those without. CONCLUSION: Dose increases with TNF inhibitors commonly occurred in RA patients in the clinical setting and were associated with greater costs of anti-TNF therapy.
Authors:
David J Harrison; Xingyue Huang; Denise Globe
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists     Volume:  67     ISSN:  1535-2900     ISO Abbreviation:  Am J Health Syst Pharm     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9503023     Medline TA:  Am J Health Syst Pharm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1281-7     Citation Subset:  IM    
Affiliation:
Global Health Economics; Amgen Inc., 1 Amgen Center Drive, Thousand Oaks, CA 91320, USA. davidh01@amgen.com
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