Biological treatments represent promising advances for individuals with rheumatoid arthritis (RA), and have been associated with significant improvement in outcomes including reduction in pain, joint swelling, serologic inflammatory indices, and rates of radiologic damage.
Few studies have examined adherence to and/or persistence on biologics in RA patients in the U.S., especially among Medicaid enrollees. Since the Medicaid population comprises a large part of our public payer health system as well as tends to be underrepresented in clinical trials, it is important to examine adherence to and discontinuation of RA biologics in such patients.
A recent study, "Adherence, Discontinuation, and Switching of Biologic Therapies in Medicaid Enrollees with Rheumatoid Arthritis" published in Value in Health, examined adherence, discontinuation, and switching of RA biologics (etanercept, anakinra, or infliximab) over a one year period following initiation of the biologic treatment in Medicaid patients with RA in California, Florida and New York. The study was co-authored by Pengxiang Li, Marissa A. Blum, Joan Von Feldt, Sean Hennessy, and Jalpa A. Doshi of University of Pennsylvania.
Says Dr. Li "This study provides valuable insights on the patterns of use of newly initiated RA biologics in routine clinical practice in three large state Medicaid programs whose combined enrollment represents approximately one-third of the total Medicaid enrollment in the U.S," Dr. Doshi adds "Our findings of poor adherence to and premature discontinuation without concurrent switching of RA biologics among patients newly initiating these highly effective but expensive agents should raise concern for clinicians as well as payers."
http://www.medicalnewstoday.com/articles/204550.php
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