Healthcare resource utilisation and economic burden of patients with adequate and inadequate responses to biological and targeted synthetic disease-modifying antirheumatic drugs for rheumatoid arthritis in Japan

Kei Ikeda; Yuko Kaneko; Yuki Tsujita; Isao Kawaguchi; Jayeshkumar Patel; Toru Yamazaki; Siran Fang; Yutaka Kawahito

doi:10.1093/mr/road106

Healthcare resource utilisation and economic burden of patients with adequate and inadequate responses to biological and targeted synthetic disease-modifying antirheumatic drugs for rheumatoid arthritis in Japan

Mod Rheumatol. 2023 Nov 9:road106. doi: 10.1093/mr/road106. Online ahead of print.

Authors

Kei Ikeda^{1

2}, Yuko Kaneko³, Yuki Tsujita⁴, Isao Kawaguchi⁴, Jayeshkumar Patel⁵, Toru Yamazaki⁴, Siran Fang⁵, Yutaka Kawahito⁶

Affiliations

¹ Department of Rheumatology, Dokkyo Medical University, Tochigi, Japan.
² Department of Allergy and Clinical Immunology, Graduate School of Medicine, Chiba University, Chiba, Japan.
³ Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
⁴ AbbVie GK, Tokyo, Japan.
⁵ AbbVie Inc., North Chicago, Illinois, USA.
⁶ Inflammation and Immunology, Graduate School of Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.

PMID: 37949632
DOI: 10.1093/mr/road106

Abstract

Objective: To compare healthcare resource utilisation (HCRU) and direct costs between responders vs non-responders to advanced therapies for rheumatoid arthritis (RA).

Methods: Patients initiating ≥1 advanced therapy (Oct 2018-Sept 2019) with ≥1 RA claim (6-month pre-index period), ≥2 RA claims (any period), and ≥12 months follow-up were identified from the Medical Data Vision claims database. HCRU and all-cause and RA-related costs (direct medical, emergency department [ED], laboratory, and pharmacy) were compared between responders vs non-responders. Adjusted incidence rate ratios (IRRs) for HCRU or cost were calculated via multivariable analyses.

Results: Among 2,446 patients (non-responders [n=1,817]; responders [n=629]), non-responders had significantly longer hospitalisation days (IRR: 1.8 [95% CI: 1.2-2.6]), and significantly more ED visits (2.5 [1.5-4.2]) and prescriptions (1.1 [1.1-1.2]). Mean all-cause hospital/outpatient medical costs were significantly higher for non-responders (1.4 [1.3-1.6], ¥530,895 vs ¥357,009 [$;3,992 vs $;2,684] for responders; ¥173,886 [$;1,307] difference); RA-related medical costs showed a similar trend (¥351,306 vs ¥253,030 [$;2,641 vs $1,902]; ¥98,276 [$;739] difference). No differences between responders and non-responders were observed in mean all-cause and RA-related pharmacy costs.

Conclusions: Non-responders to advanced therapies had greater HCRU and all-cause/RA-related direct costs as compared with responders, suggesting a need for more effective RA therapies to reduce the economic burden associated with non-response.

Keywords: Disease-modifying antirheumatic drugs; economic burden; healthcare resource utilisation; responder; rheumatoid arthritis.