Background/Purpose: Treatment abandonment (failure to start therapy after prescription) is common among patients (pts) prescribed specialty pharmaceuticals. AbbVie offers a pt support program (PSP) for adalimumab (ADA)-treated pts, which includes assistance with medication costs, nurse support, injection training, pen disposal and medication reminders.¹ PSP may reduce abandonment in RA, ankylosing spondylitis (AS) and psoriatic arthritis (PsA). We investigated associations between PSP and rate of ADA treatment abandonment in US pts with RA, AS and PsA.

Methods: A longitudinal study was conducted using pt-level data from AbbVie’s PSP database linked with Source Healthcare Analytics US claims data. Pts aged ≥18 years with a RA, AS or PsA diagnosis, ≥1 pharmacy claim (paid or reversed) for ADA and no ADA claim before 2012 were included; the index date was the first ADA claim from 1/2012–1/2015. Pts required medical coverage ≥3 months pre-index date and pharmacy coverage ≥3 months pre-/post-index date. Abandonment was defined as reversal of first ADA claim (eg, pt did not take possession of medication) with no paid claim during 3 months of follow-up. Abandonment rate was compared between pts who enrolled in any component of the PSP (PSP cohort) vs those who did not (non-PSP cohort) within 30 days of treatment initiation using 2-sample z-test of proportions. The likelihood of abandonment was assessed using logistic regression, controlling for baseline characteristics.

Results: A total of 16780 pts (RA: 6200 PSP, 6155 non-PSP; AS: 451 PSP, 525 non-PSP; PsA: 1785 PSP, 1664 non-PSP) were included. At baseline in RA and PsA, PSP pts were younger (50.5 vs 52.0 yr; P<.0001 and 48.5 vs 49.3 yr; P=.042, respectively) and less likely to be male (20.4% vs 22.5%; P=.005 and 41.2% vs 47.8%; P=.0001, respectively) than non-PSP pts. No significant difference was observed regarding age in AS, but PSP pts were less likely to be male vs non-PSP pts (50.1% vs 57.7%; P=.018). The PSP cohort had lower expected per-patient out of pocket contribution for ADA across diseases (RA [$222 vs $312; P<.0001], AS [$136 vs $240; P<.0001] and PsA [$179 vs $261; P<.0001]) and greater frequency of specialty pharmacy use for first ADA fill (RA: 55.7% vs 47.3%; P<.0001, AS: 65.4% vs 49.5%; P<.0001, PsA: 58.8% vs 54.8%; P=.0173). After controlling for baseline characteristics among PSP vs non-PSP pts, abandonment risk was 78% lower in RA (6.0% vs 26.4%; odds ratio [OR]=0.22; P<.0001), 85% lower in AS (3.8% vs 20.2%; OR=0.15; P<.0001) and 77% lower in PsA (4.8% vs 21.9%; OR=0.23; P<.0001) (Figure).

Conclusion: Enrollment in AbbVie’s free-to-patient PSP was associated with 77–85% reduced abandonment of ADA treatment among US pts with RA, AS and PsA.   References: 1. https://www.humira.com/humira-complete