Impact of non-persistence on healthcare resource utilization and costs in patients with immune-mediated rheumatic diseases initiating subcutaneous TNF-alpha anhibitors: a before-and-after study

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• dc.contributor.author Carballo Martínez, Núria
• dc.contributor.author García-Alzórriz, Enric
• dc.contributor.author Ferrández, Olivia
• dc.contributor.author Navarrete Rouco, Maria Eugenia
• dc.contributor.author Duran Jordà, Xavier, 1974-
• dc.contributor.author Pérez-García, Carolina
• dc.contributor.author Monfort Faure, Jorge
• dc.contributor.author Cots Reguant, Francesc
• dc.contributor.author Grau Cerrato, Santiago
• dc.date.accessioned 2022-07-29T06:46:39Z
• dc.date.available 2022-07-29T06:46:39Z
• dc.date.issued 2021
• dc.description.abstract Rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis are chronic progressive immune-mediated rheumatic diseases (IMRD) that can cause a progressive disability and joint deformation and thus can impact in healthcare resource utilization (HCRU) and costs. The main outcome of the study was to assess the effect of non-persistence to treatment with subcutaneous tumor necrosis factor-alpha inhibitors (SC-TNFis) on HCRU costs in naïve patients with IMRD who started treatment with adalimumab, etanercept, golimumab or certolizumab pegol during 12 months after initiation of treatment. The impact of persistence and non-persistence of SC-TNFis on HCRU costs was compared between 12 months before and 12 months after initiating SC-TNFis. Persistence was defined as the duration of time from initiation to discontinuation of therapy. The study was conducted in an acute care teaching hospital in Barcelona, Spain. Data for the period between 2015 and 2018 were extracted from the hospital cost management control database. HCRU costs comprised outpatient care, outpatient specialized rheumatology care, in-patient care, emergency care, laboratory testing and other non-biological therapies. The study population included 110 naïve SC-TNFis patients, divided into the cohorts of persistent (n = 85) and non-persistent (n = 25) patients. Fifty-six percent of patients were women, with a mean (standard deviation) age of 47.6 (14.8) years. Baseline clinical features and HCRU costs over the 12 months before the index prescription were similar in the two study groups. Before-and-after differences in mean (standard deviation) HCRU costs were significantly higher in the non-persistence group as compared to the persistence group for outpatient rheumatology care (€110.90 [234.56] vs. €20.80 [129.59], p = 0.023), laboratory testing (-€193.99 [195.88] vs. -€241.3 [217.88], p = 0.025), other non-biological drugs (€3849.03 [4046.14] vs. -€10.90 [157.42], p < 0.001) and total costs (€3268.90 [4821.55] vs. -€334.67 (905.44), p < 0.001). Treatment persistence with SC-TNFis may be associated with HCRU cost savings in naïve IMRD patients. Prescribing SC-TNFis with the best long-term persistence is beneficial.
• dc.format.mimetype application/pdf
• dc.identifier.citation Carballo N, Garcia-Alzórriz E, Ferrández O, Navarrete-Rouco ME, Durán-Jordà X, Pérez-García C, et al. Impact of non-persistence on healthcare resource utilization and costs in patients with immune-mediated rheumatic diseases initiating subcutaneous TNF-alpha anhibitors: a before-and-after study. Front Pharmacol. 2021 Nov 29; 12: 752879. DOI: 10.3389/fphar.2021.752879
• dc.identifier.doi http://dx.doi.org/10.3389/fphar.2021.752879
• dc.identifier.issn 1663-9812
• dc.identifier.uri http://hdl.handle.net/10230/53890
• dc.language.iso eng
• dc.publisher Frontiers
• dc.rights Copyright © 2021 Carballo, Garcia-Alzórriz, Ferrández, Navarrete-Rouco, Durán-Jordà, Pérez-García, Monfort, Cots and Grau. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) http://creativecommons.org/licenses/by/4.0/. The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by/4.0/
• dc.subject.keyword Ankylosing spondylitis
• dc.subject.keyword Biologics
• dc.subject.keyword Healthcare resource consumption
• dc.subject.keyword Persistence
• dc.subject.keyword Psoriatic arthritis
• dc.subject.keyword Rheumatic disease
• dc.subject.keyword Rheumatoid arthritis
• dc.title Impact of non-persistence on healthcare resource utilization and costs in patients with immune-mediated rheumatic diseases initiating subcutaneous TNF-alpha anhibitors: a before-and-after study
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion