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Is Patient Support Program Participation Associated with Longer Persistence and Improved Adherence Among New Users of Adalimumab? A Retrospective Cohort Study

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Abstract

Introduction

Adalimumab (ADA) is a medication used in the treatment of several autoimmune diseases. Despite the beneficial effects of ADA, its adherence and persistence rates are low. Patients treated with ADA from Clalit Health Services (CHS) can enroll in AbbVie’s patient support program (PSP), which aims to improve ADA adherence and persistence. Therefore, we examine whether PSP participation is associated with a longer persistence and/or an improved adherence to ADA.

Methods

A real-world retrospective cohort study of all new ADA users from CHS, comparing those enrolled in the offered PSP to those not enrolled. The data regarding PSP users can be tracked using CHS’s data warehouse. The index date was defined as the date of the patients’ first purchase of ADA occurring between August 1, 2012 and December 31, 2014. The follow-up data were collected at 12, 24, and 36 months. Persistence was assessed using survival analyses of time until discontinuation, and adherence was assessed using medication possession ratio (MPR).

Results

There were 1520 patients in the study, 755 (49.7%) of whom were PSP users. PSP users were 54.3% female vs. 51.9% among non-PSP users (p = 0.355) and they were significantly younger than non-PSP users (mean age 42.3 vs. 45.0 years, p = 0.002) The PSP and non-PSP users’ persistence was 673 and 574 days, respectively (p < 0.001). Further, the PSP users were more likely than the non-PSP users to be persistently taking medication at the 12-month follow-up (57.5% vs. 45.6%, p < 0.001). The 12-month mean adherence rate among those with at least 12 months of persistence was significantly improved for the PSP users compared to the non-PSP users (94.1% vs. 92.9%, p = 0.026).

Conclusion

The AbbVie PSP provided to CHS patients was associated with a longer persistence among new users of ADA. It was also associated with significantly higher adherence rate within the first 12 months.

Funding

AbbVie Inc.

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Acknowledgements

Funding

Design, study conduct, and financial support for the study were provided by AbbVie Inc. The Clalit Research Institute funds the article processing charges. All authors contributed in the interpretation of data, review, and approval of the manuscript. All authors contributed to the development of the publication and maintained control over the final content. Clalit Research Institute authors had full access to all of the data in this study and take complete responsibility for the integrity of the data and accuracy of the data analysis. AbbVie authors had full access to the aggregated data and study tables.

Authorship

All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval for the version to be published.

Medical Writing, Editorial, and Other Assistance

Editorial assistance in the preparation of this manuscript was provided by Sydney Krispin, MPH, and Carly Davis-Pask, MPH, both of the Clalit Research Institute, Israel.

Disclosures

Martha Skup is an employee of AbbVie and may own company stock. Vishvas Garg is an employee of AbbVie and may own company stock. Einav Srulovici, Adi Ghilai, Becca Feldman, Moshe Hoshen, Ran D Balicer, and Maya Leventer-Roberts have nothing to disclose.

Compliance with Ethics Guidelines

This study received approval from Clalit Health Services institutional review board and conforms with the 1964 Declaration of Helsinki.

Data Availability

The data sets generated during and/or analyzed during the current study are not publicly available because public availability would compromise patient confidentiality. The data restrictions are imposed by the Clalit Health Services Data Utilization Committee and the Clalit Health Services Internal Review board in order to protect patient confidentiality. Clalit Health Services Internal Review board Helsinki Committee at “Meir” Medical center in Kfar Saba’s contact info is: Phone: +972-9-7471588, Fax: +972-9-7471602. Clalit Health Services Data Utilization Committee’s contact information is: 101 Arlozorov St. Tel Aviv, Israel, Phone, +972-3-7170124. Future researchers can obtain the aggregated (anonymized) data from Dr. Noa Dagan at Noada@clalit.org.il or +972-3-6925809.

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Authors and Affiliations

  1. Department of Nursing, University of Haifa, Haifa, Israel

    Einav Srulovici

  2. Clalit Health Services, Clalit Research Institute, Tel Aviv, Israel

    Einav Srulovici, Adi Ghilai, Becca Feldman, Moshe Hoshen, Ran D. Balicer & Maya Leventer-Roberts

  3. AbbVie Inc, North Chicago, IL, USA

    Vishvas Garg & Martha Skup

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  1. Einav Srulovici
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Correspondence to Einav Srulovici.

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Srulovici, E., Garg, V., Ghilai, A. et al. Is Patient Support Program Participation Associated with Longer Persistence and Improved Adherence Among New Users of Adalimumab? A Retrospective Cohort Study. Adv Ther 35, 655–665 (2018). https://doi.org/10.1007/s12325-018-0706-0

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