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Changes in Utilization and Costs for Patients with Rheumatoid Arthritis, 1997 to 2006

  • Original Research Article
  • Rheumatoid Arthritis Patient Costs 1997–2006
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Abstract

Background: Rheumatoid arthritis (RA) is a chronic autoimmune disease that often results in joint pain, inflammation and bone erosions. Perhaps the most notable change in RA treatment during the last decade is the advent of biologics, and, in particular, anti-tumour necrosis factor agents. Given these advances, it is useful to assess how healthcare and work-loss costs of patients with RA have changed.

Objective: Our objective was to assess changes in healthcare utilization and costs from 1997 to 2006 for patients diagnosed with RA.

Methods: Two cohorts (1997 and 2006) of patients withRAandmatched controls were identified fromtwo administrative claims databases along with subsamples of employed patients and matched controls. The analysis focused on the more homogeneous employee subsample. We compared annual excess co-morbidity rates, resource utilization and healthcare and work-loss costs per patient between the 1997 (n= 279) and 2006 cohorts (n= 837) with difference-in-differences methodology. Results with p < 0.05 were considered statistically significant.

Results: In the employee subsample, there were no statistically significant differences in the excess prevalence of non-RA co-morbidities or Charlson Co-morbidity Index results, except for cardiovascular disease, which decreased by 11.1%. Excess number of ED visits and days hospitalized decreased by 1.1 visits/patient and 0.9 days/patient, respectively, while rheumatologist visits increased by 0.9 visits/patient. Excess per-patient direct costs were unchanged. However, drug costs increased by $US633/patient, but medical costs decreased by $US618/patient (not significant) [year 2006 values].

Conclusion: For employed patients with RA, there were significant reductions in per-patient excess hospital days, as well as ED visits, and no changes in excess total direct costs over time. New treatments introduced during the study period may be associated with cost savings that offset changes in employee utilization of drug and medical services. In addition, the reductions in excess ED visits and hospital days suggest improvements in patient quality of life.

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Acknowledgements

This research was funded by Abbott Laboratories. Data were analysed by Analysis Group, Inc.

Dr Birnbaum, Ms Pike, Dr Banerjee and Ms Waldman are employees of Analysis Group, which received funding from Abbott Laboratories for this research. Dr Cifaldi is an employee of and owns stock in Abbott Laboratories.

As the corresponding and principal author, Dr Birnbaum, along with his colleagues Ms Pike, Dr Banerjee and Ms Waldman, designed the analysis plan, conducted the analysis, had sole control over the data, wrote manuscript drafts and revisions, and provided final approval for the manuscript. Dr Cifaldi contributed to the study conception and statistical analyses, interpretation of results, reviewed manuscript drafts, and provided feedback and approval for the manuscript. As the primary author, incorporation of all suggestions and feedback were at Dr Birnbaum’s discretion and he is the guarantor for the overall content of this article.

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Authors and Affiliations

  1. Analysis Group, Inc., 111 Huntington Avenue, 10th floor, Boston, MA, 02199, USA

    Howard G. Birnbaum PhD, Crystal Pike, Ritesh Banerjee & Tracy Waldman

  2. Global Health Economics and Outcomes Research, Abbott Laboratories, Abbott Park, IL, USA

    Mary Cifaldi

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  1. Howard G. Birnbaum PhD
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Correspondence to Howard G. Birnbaum PhD.

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Birnbaum, H.G., Pike, C., Banerjee, R. et al. Changes in Utilization and Costs for Patients with Rheumatoid Arthritis, 1997 to 2006. PharmacoEconomics 30, 323–336 (2012). https://doi.org/10.2165/11589470-000000000-00000

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