Treatment patterns and costs for anti-TNFα biologic therapy in patients with psoriatic arthritis
Treatment patterns and costs for anti-TNFα biologic therapy in patients with psoriatic arthritis
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DOI：
10.1186/s12891-016-1102-z
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发表时间：
2016-06-14
影响因子：
2.3
通讯作者：
Ozturk, Zafer E.
中科院分区：
文献类型：
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作者：
Palmer, Jacqueline B.;Li, Yunfeng;Ozturk, Zafer E.
背景资料：关于抗肿瘤坏死因子α的真实世界数据（抗TNF α）生物治疗在银屑病关节炎（PsA）中的应用是有限的;因此，我们描述了美国PsA患者抗TNF α治疗的治疗模式和费用。从MarketScan索赔数据库（2009年10月1日至2010年9月30日）中选择开始抗TNF α治疗的≥ 18岁的PsA患者（N = 990）。接受抗TNF α一线（n = 881）、二线（n = 72）或三线或以上（n = 37）治疗的患者数量、持续性、转换或调整的时间、药房和医疗费用在3年的随访中观察了每种治疗方法的平均住院时间（每例患者每月测量的PPPM）。仅接受一线抗TNF α治疗的PsA患者分别维持一线治疗约17个月，而改用二线或三线或以上治疗的PsA患者分别维持一线治疗约11至12个月。转换至三线或三线以上治疗的患者（7个月）至一线调整的时间长于未转换或转换至二线治疗的患者（范围，相似于2至4个月）。对于接受三线或三线以上治疗的患者，每种治疗线的转换时间和一线调整时间逐渐缩短。PPPM的医疗费用较高的患者谁没有转换（322美元）比那些谁转换到二线（167美元）或三线或以上（217美元）。PPPM药房费用是更大的三线或更高的治疗（2539美元）的患者比那些谁没有开关（1985美元）或切换到二线（2045美元）。结论：虽然大多数患者只接受一线抗TNF α治疗，一个子集的患者切换到多线治疗在3年的随访期间。这些患者和仅接受一线治疗的患者之间的持续性和治疗调整不同。没有转换的患者的总体医疗费用最高，随着患者转换到每一种新的治疗线，药房费用也会增加。
Background: Real-world data regarding anti-tumor necrosis factor alpha (anti-TNF alpha) biologic therapy use in psoriatic arthritis (PsA) are limited; therefore, we described treatment patterns and costs of anti-TNF alpha therapy in PsA patients in the United States.Methods: PsA patients (N = 990) aged = 18 years who initiated anti-TNF alpha therapy were selected from MarketScan claims databases (10/1/2009 to 9/30/2010). Number of patients on first-(n = 881), second-(n = 72), or third-or greater (n = 37) line of anti-TNF alpha therapy, persistence, time-to-switch or modification, pharmacy and medical costs (measured per patient per month [PPPM]) for each line of therapy were observed during the 3-year follow-up.Results: PsA patients receiving only one line of anti-TNF alpha therapy remained on first-line for similar to 17 months while those who switched to second-or third-or greater persisted on first-line for similar to 11 to 12 months, respectively. Time to first-line modification was longer for patients who switched to third-or greater line therapy (7 months) than those who did not switch or switched to second-line (range, similar to 2 to 4 months). Time-to-switch and time to first-line modification was progressively shorter with each line of therapy for patients who received third-or greater line. PPPM medical costs were higher for patients who did not switch ($322) than those who switched to second-($167) or third-or greater ($217) line. PPPM pharmacy costs were greater for patients with third-or greater line therapy ($2539) than those who did not switch ($1985) or switched to second-line ($2045).Conclusion: While the majority of patients received only one line of anti-TNF alpha therapy, a subset of patients switched to multiple lines of therapy during the 3-year follow-up period. Persistence and therapy modifications differed between these patients and those receiving only one line. Overall medical costs were highest for patients who did not switch, and pharmacy costs increased as patients switched to each new line of therapy.