Patient Support Program Improves Adherence to TNF Inhibitors in RA and IBD

Despite trials showing that antitumor necrosis factor (TNF) therapy is safe and effective to treat inflammatory diseases such as inflammatory bowel disease and rheumatoid arthritis, adherence rates remain low.

A new study in Journal of Managed Care & Specialty Pharmacy examined the relationship between participation in a free patient support program (PSP) offered by AbbVie to assist with medication costs, nurse support, injection training, pen disposal, and medication reminders for patients using adalimumab.

“The PSP assessed in this study is a continuously evolving program that was designed to improve the overall patient experience with chronic inflammatory disease and its management,” the authors explained. “It provides a broad range of resources to support patients throughout their treatment with adalimumab, including frequent contact with trained health care providers.”

Previous research has shown that nonadherence to anti-TNF therapies exceeds 40%, which is a higher nonadherence rate than typically observed in other disease conditions. Evidence suggests that nonadherence in this space is a result of various factors, such as patient—provider relationships, social support, patient beliefs about medication and whether health behaviors affect future health, and age.

“In order to address possible risk factors for nonadherence, there is a growing trend to offer PSPs to help patients and health care professionals better manage disease and optimize treatment,” the authors wrote.

A total of 3284 patients were included in the study, with 1370 in the PSP cohort and 2454 in the non-PSP cohort. The majority of patients in each cohort had rheumatoid arthritis, and the most common comorbidities were hypertension, hyperlipidemia, and diabetes.

The researchers found that patients in the PSP cohort had greater adherence and persistence to adalimumab. Those in the PSP also had a 14% greater proportion of days covered and a 14% lower discontinuation rate over 12 months.

Since the PSP patients were more adherent, their drug costs were 9% greater, but total costs were 10% lower compared with non-PSP patients. While costs were similar at baseline, the PSP cohort had significantly lower medical costs over 12 months compared with the non-PSP patients ($18,322 vs $23,679). The researchers attributed the lower costs to a reduction in inpatient costs.

“Enrollment in the PSP was associated with increased adalimumab adherence and persistence, reduced medical costs (all-cause and disease-related), and reduced total healthcare costs,” the authors wrote. “These data provide support for prescribing physicians to encourage enrollment in PSPs for inflammatory conditions and for pharmaceutical companies to further develop and invest in multifaceted PSPs.”