Details

Autor(en) / Beteiligte

• Weycker, Derek
• Yu, Elaine B.
• Michael Woolley, J.
• Oster, Gerry

Titel

Retrospective study of the costs of care during the first year of therapy with etanercept or infliximab among patients aged ≥65 years with rheumatoid arthritis

Ist Teil von

• Clinical therapeutics, 2005-05, Vol.27 (5), p.646-656

Ort / Verlag

Belle Mead, NJ: Elsevier Inc

Erscheinungsjahr

2005

Quelle

MEDLINE

Beschreibungen/Notizen

• Abstract The aim of this work was to retrospectively examine the costs of therapy with etanercept and infliximab, among patients aged ≥ 65 years with rheumatoid arthritis (RA), from a health-care system perspective. Data from 2 large, automated US health-care claims databases (Constella COMPASS and Ingenix LabRx) were pooled for the analyses. Each database is comprised of paid facility, professional service, and retail (ie, outpatient) pharmacy claims from participating health plans. Using the 2 databases, all RA patients aged ≥65 years were identified who began therapy with etanercept or infliximab between July 1, 1999 (Constella COMPASS), or January 1, 2001 (Ingenix LabRx), and December 31, 2002. Costs of RA-related care (including study drugs, selected medications, and outpatient encounters for RA) and non-RA-related care (all other medications and services) for patients in the 2 treatment groups were assessed, in US dollars, over a 1-year period after therapy initiation. A total of 280 RA patients aged ≥ 65 years initiated therapy with etanercept (n = 99) or infliximab (n = 181) and met all other selection criteria. Etanercept patients were younger than infliximab patients (mean [SD] age, 70.5 [4.6] vs 71.8 [4.6] years; P = 0.04), were less likely to be enrolled in a managed care organization (76.7% vs 87.8%; P < 0.01), and had fewer pretreatment rheumatologist visits (mean [SD], 1.3 [2.3] vs 2.2 [3.8]; P = 0.04). Other characteristics, including pretreatment levels of other types of health-care utilization, were generally similar. Mean (95% CI) total cost of RA-related care was lower for etanercept patients in both databases ($12,159 [$10,795-$13,380] for etanercept vs $22,347 [$20,808-$23,912] for infliximab in one, and $14,297 [$12,238-$16,326] for etanercept vs $22,154 [$19,688-$24,703] for infliximab in the other), primarily due to lower costs of anti-tumor necrosis factor therapy ($10,015 [$8754-$11,224] for etanercept vs $18,611 [$17,169-$20,023] for infliximab in one database; $11,917 [$10,128-$13,480] for etanercept vs $16,759 [$14,551-$19,062] for infliximab in the other). Mean (95% CI) costs of non-RA-related care were similar among etanercept and infliximab patients in both databases ($13,100 [$8956-$18,377] for etanercept vs $11,789 [$8326-$16,001] for infliximab in one, and $16,665 [$10,329-$25,690] for etanercept vs $13,959 [$10,216-$18,168] for infliximab in the other). These results suggest that costs of RA-related care during the first year of therapy may be lower among RA patients aged ≥65 years receiving etanercept versus infliximab, a difference attributable primarily to lower costs of drug acquisition.