Use of Biologic DMARDs Has Increased Among RA Patients

Recently, the use of biologic disease-modifying antirheumatic drugs (bDMARDs) have increased among patients with rheumatoid arthritis, especially among Medicaid patients with RA.

A study recently published by the Journal of Managed Care & Specialty Pharmacy utilized time trends of bDMARDs use among RA patients to investigate their prevalence among those with private or public insurance in the United States. Researchers collected private claims data from Optum Clinformatics from 2004 to 2015, and public claims from Medicaid Analytic eXtract from 2000 to 2010. The study created 2 cohorts: one group with patients not using any bDMARD and another with patients using a single bDMARD during the baseline period.

“Use of bDMARDs in recent years has contributed to the markedly increased remission rates of RA, and sustained remission is known to result in economic benefits to the healthcare system in the form of reduced use of health services in addition to improved quality of life and patient productivity,” the researchers explained.

In total, 113,031 RA patients with public insurance were included in the study, while 97,751 RA patients with private insurance were also included. During the 10-year follow-up period, the researchers found that the initiation rates of bDMARDS, per 100 patients, had significantly increased among the Medicaid data for incident RA patients and for prevalent RA patients.

Additionally, the rate of switching to a bDMARD increased from 6.4 to 16 for Medicaid data and 9.1 to 17 in Optum Clinformatics data. Through the research, the study also found that etanercept was the most common first-line agent and was stable for approximately 50% of all biologic initiations.

The study explained that this increase in the use of bDMARDs was a result of the greater number of available treatment options, which increased from 3 in 2002 to 10 since 2012. In addition, physicians have become more experienced and informed on these agents, leading to an increased use.

“The observation of widespread uptake of these agents from this study further highlights the importance of continuing research to guide evidence-based decision making for patients with RA,” the authors concluded. “With the introduction of biosimilars into the market in the near future, closely monitoring patterns, pricing, and outcomes of biologic use in RA would provide important insights.”