Rheumatoid arthritis (RA) patients who regularly adhere to their prescription drug regimen have fewer emergency room and doctor visits and incur lower medical costs, according to research presented today by Medco Health Solutions, Inc. (NYSE: MHS) at the American College of Rheumatology's Annual Meeting in Philadelphia. The study examined differences in RA patient medication adherence, use of medical services, and treatment costs when patients using either adalimumab (Humira®) or etanercept (Enbrel®) obtained these medications through specialty or retail pharmacies.
"This study fills a research void for patients with rheumatoid arthritis. While many studies have shown an association between increased adherence, better clinical outcomes, and lower costs in non-specialty medications, this study is one of the first to show a link between specialty pharmacy management in patients with RA and these outcomes." said Dr. Jane F. Barlow, lead author and vice president of Medical Strategy and Clinical Quality at Medco. "The research also showed that specialty pharmacy patients used fewer medical services suggesting better control of the disease."
The study compared the medical and pharmacy claims of 4,388 patients with RA who filled their prescriptions for adalimumab or etanercept through a specialty pharmacy or through a retail pharmacy from 2006 to 2008. After 2 years, patients who used a specialty pharmacy had a 16.0 percent higher adherence rate and on average, had $1,534 lower annual medical costs than those using a retail pharmacy. The reductions in medical service costs were tied to physician and ER visits. The study also found that because of the more consistent use of medications by specialty patients, medication costs adjusted to average wholesale price were higher.
"The study only measured direct medical costs, but indirect costs of RA from disability and absenteeism are a big factor for employers when they have employees with RA," Barlow said. "Specialty pharmacies can mitigate medical and indirect costs, which can offset the cost of the medications." The indirect costs for RA patients from lost productivity can be as much or more as the direct medical costs.
RA afflicts 1.3 million
Approximately 1.3 million patients have RA, which is characterized by pain and swelling in the joints driven by the body's immune system attacking the lining of the joints. Joint destruction for RA patients can occur within two years of the onset of the disease. The condition can strike at any age, but most commonly begins between 35-50 years of age. Women are more than twice as likely to be affected by the condition as men. RA is the leading cause of disability in the US and severely disables about 10 percent of all patients. It decreases life expectancy by three to seven years with heart disease, infection, and gastro-intestinal bleeding accounting for most of those deaths. Improved treatment has slowed the progression of the disease and allows the vast majority of patients to live normal lives. TNF inhibitors, which are commonly prescribed for the condition, help interfere with inflammation associated with RA and other autoimmune disorders, such as Crohn's disease and moderate-to-severe cases of plaque psoriasis.