Tumor necrosis factor blocker dose escalation among biologic naïve rheumatoid arthritis patients in commercial managed-care plans in the 2 years following therapy initiation

Journal of Medical Economics
Machaon BonafedeKathleen L Wilson

Abstract

This study uses real-world US managed-care claims data to estimate dose escalation rates over the first and second years of therapy among biologic naïve rheumatoid arthritis (RA) patients initiating tumor necrosis factor (TNF) blocker therapy with etanercept, adalimumab, or infliximab. Non-elderly adult (age 18-65 years) RA patients initiating etanercept, adalimumab, or infliximab from July 1, 2005 to April 30, 2009, were identified using the MarketScan Commercial Database. National and regional dose-escalation patterns were evaluated 12 and 24 months after initiation. In the single-instance method, dose escalation was defined as having one average weekly dose 115%, 130%, or 150% greater than the initial average weekly dose. By the two-instances method, dose escalation was defined as having two consecutive claims with an average weekly dose 115% or 130% greater than the initial average weekly dose. A total of 2747 patients met the inclusion criteria (mean age 50 years [SD=10]; 74% female). More patients initiated etanercept (44%) than adalimumab (37%) or infliximab (20%). Using the single-instance method, dose escalation at 12 months ranges were 0.8-1.5% for etanercept, 10.8-12.5% for adalimumab, and 16.4-42.5% for infliximab; ...Continue Reading

References

Dec 20, 2007·Scandinavian Journal of Rheumatology·R F van Vollenhoven, L Klareskog
Apr 19, 2008·BMC Musculoskeletal Disorders·Alberto Alonso-RuizAntonio Quintana
Jul 24, 2010·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·David J HarrisonDenise Globe
Nov 12, 2010·Annals of the Rheumatic Diseases·Anna JamnitskiGerrit Jan Wolbink
Apr 14, 2011·JAMA : the Journal of the American Medical Association·Geertje M BarteldsGerrit Jan Wolbink

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Citations

Mar 2, 2018·Modern Rheumatology·Katsuhiko TakabayashiTakahiro Suzuki
Feb 2, 2015·Rheumatology International·Rafael Ferriols-Lisart, Francisco Ferriols-Lisart

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