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Abstract Number: 0060

Lower Healthcare Costs for Commercially Insured Patients with Rheumatoid Arthritis in Remission

Jeffrey Curtis1, Kathleen Fox2, Fenglong Xie3, Yujie Su3, David Collier4, Cassie Clinton3 and Hafiz Oko-osi5, 1Division of Clinical Immunology & Rheumatology, University of Alabama at Birmingham, Birmingham, AL, 2Strategic Health (formerly with Amgen), Thousand Oaks, CA, 3University of Alabama at Birmingham, Birmingham, AL, 4Amgen Inc., Simi Valley, CA, 5Gilead Sciences, Foster City, CA

Meeting: ACR Convergence 2022

Keywords: Cost-Effectiveness, Pharmacoepidemiology, rheumatoid arthritis

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Session Information

Date: Saturday, November 12, 2022

Title: Health Services Research Poster I: Lupus, RA, Spondyloarthritis and More

Session Type: Poster Session A

Session Time: 1:00PM-3:00PM

Background/Purpose: Rheumatoid arthritis (RA) affects about 1-2% of adults with annual US costs at $19 billion. Most studies evaluating cost of care have not had sufficient data from real-world settings to describe costs and healthcare utilization by RA disease activity (DA) or therapy.

Methods: This retrospective study linked medical and prescription claims to disease activity measures in electronic health record (EHR) data over 1/1/10-3/31/20 using the Optum Clinformatics Data Mart and Bendcare Columbus Real-World Evidence Platform. Annual mean costs were stratified on disease activity and use of conventional synthetic (cs) DMARDs, biologics, and targeted (ts) DMARDS in a 12-month baseline period. A subgroup analysis compared costs in patients initiating a new RA therapy in the 6 months baseline to months 4-10 after initiation. <

Results: A total of 2339 patients contributed a mean of 1.42 years of follow-up. At baseline, 440 (19%) were in remission, 936 (40%) in low DA (LDA), 676 (29%) in moderate DA (MDA) and 287 (12%) in high DA (HDA). The Remission and LDA cohorts were slightly older; all cohorts were predominantly female and Caucasian. Mean annual costs were less for patients in remission ($40,165) versus those in MDA ($56,536) and HDA ($59,279). For patients in remission, csDMARD use was associated with the lowest mean annual cost ($25,564), tsDMARDs highest ($75,453), and TNFi ($69,661) and non-TNFi ($57,299) intermediate. Patients in LDA were similar: $31,251 csDMARDs; $70,422 TNFi; $68,563 non-TNFi, and $97,127 tsDMARDs. In the subgroup initiating a new RA therapy (n=137 TNFi and 107 non-TNFi), 43 (31.4%) and 28 (26.2%) attained LDA/remission (TNFi and non-TNFi respectively), and patients initiating TNFi had a shorter time to remission/LDA compared to non-TNFi initiators (123 vs. 149 days). For those on biologics, annual mean within-person medical ($-2,835.41) and inpatient costs (-$2,718.17) were lower after LDA/remission, but pharmacy costs were higher (post-pre initiation difference $18,326.69).

Conclusion: Higher cost of care was observed as RA disease activity increased, with patients in remission having the lowest costs. Optimizing disease activity can have substantial savings in healthcare costs although it may be offset by the cost of targeted RA therapies.


Disclosures: J. Curtis, Amgen, Bristol-Myers Squibb (BMS), CorEvitas, IlluminationHealth, Janssen, Lilly, Myriad, Novartis, Pfizer, Sanofi, UCB, Aqtual, Bendcare, FASTER, GlaxoSmithKlein (GSK), Labcorp, Scipher, Setpoint, United Rheumatology, AbbVie, ArthritisPower; K. Fox, Amgen, Inc.; F. Xie, Bendcare; Y. Su, None; D. Collier, Amgen; C. Clinton, None; H. Oko-osi, BioMarin, Amgen, Gilead.

To cite this abstract in AMA style:

Curtis J, Fox K, Xie F, Su Y, Collier D, Clinton C, Oko-osi H. Lower Healthcare Costs for Commercially Insured Patients with Rheumatoid Arthritis in Remission [abstract]. Arthritis Rheumatol. 2022; 74 (suppl 9). https://acrabstracts.org/abstract/lower-healthcare-costs-for-commercially-insured-patients-with-rheumatoid-arthritis-in-remission/. Accessed .
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