ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 1134

Medicaid Spending (2013-2017) on Disease Modifying Agents Commonly Used in Rheumatoid Arthritis

Deepan Dalal1, Tingting Zhang 2 and Theresa Shireman 2, 1Brown University, Riverside, RI, 2Brown University, Providence, RI

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: Disease-modifying antirheumatic drugs, rheumatoid arthritis (RA) and health care cost

  • Tweet
  • Email
  • Print
Session Information

Date: Monday, November 11, 2019

Session Title: Health Services Research Poster II – ACR/ARP

Session Type: Poster Session (Monday)

Session Time: 9:00AM-11:00AM

Background/Purpose: The management of rheumatoid arthritis (RA) and other conditions have improved tremendously since the introduction of biologic disease modifying agents (DMARDs). However, these agents command a substantial price, adding more $20,000 to direct medical care costs in people with RA. We examined recent trends in Medicaid (public health insurance for low income US citizens) spending on DMARDs in this era of biologics.

Methods: We compiled data from 5 years (2013-17) of publicly available Medicaid spending reports: total expenditures (before rebates), unit costs, and doses dispensed at the product level. Expenditures were summed and compared between conventional and biologics DMARDs.

Results: Spending on conventional DMARDs increased from $24.2 million to $92.3 million (Fig 1): two-thirds was attributable to hydroxychloroquine which experienced a substantial increase in the price/unit ($0.22 to $1.31). Leflunomide unit costs also more than doubled and spending increased 4.4-fold.  Methotrexate and sulfasalazine unit costs were stable.

Spending on biologics increased from $894 million to $3.1 billion: driven by a 5-fold increase in total spending on adalimumab whose cost/unit doubled (Fig 2). Spending on etanercept and infliximab increased more than doubled, unit cost increased by 82% and 45% respectively. Total spending on abatacept increased 5-folds ($19 million to $102 million).

Conclusion: Biologic agents has pushed Medicaid’s expenditures for DMARDs from $918.2 million to more than $3 billion in just 5 years. Two conventional DMARDs had substantial unit cost increases, but their expenditure level remained a fraction (3%) of total DMARD spending. While not all of the biologics were used for RA, these increases should be carefully considered relative to their clinical benefit.

Figure 1: Trends in Medicaid Spending for conventional DMARDs

Figure 2: Trends in Medicaid Spending for biologic DMARDs


Disclosure: D. Dalal, None; T. Zhang, None; T. Shireman, None.

To cite this abstract in AMA style:

Dalal D, Zhang T, Shireman T. Medicaid Spending (2013-2017) on Disease Modifying Agents Commonly Used in Rheumatoid Arthritis [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/medicaid-spending-2013-2017-on-disease-modifying-agents-commonly-used-in-rheumatoid-arthritis/. Accessed January 27, 2023.
  • Tweet
  • Email
  • Print

« Back to 2019 ACR/ARP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/medicaid-spending-2013-2017-on-disease-modifying-agents-commonly-used-in-rheumatoid-arthritis/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2023 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences