Michael Ruberson Ribeiro da Silva1, Jéssica Barreto Ribeiro Dos Santos1, Alessandra Maciel Almeida2,3, Augusto Afonso Guerra Júnior2, Juliana Alvares Teodoro2, Francisco de Assis Acurcio2,4. 1. a Postgraduate Program in Medicines & Pharmaceutical Services, College of Pharmacy, Federal University of Minas Gerais , Minas Gerais , Brazil. 2. b College of Pharmacy, Federal University of Minas Gerais , Minas Gerais , Brazil. 3. c Institute of Research and Postgraduate in Medical Sciences, Faculty of Medical Sciences of Minas Gerais , Minas Gerais , Brasil. 4. d Department of Social and Preventive Medicine, School of Medicine, Federal University of Minas Gerais , Minas Gerais , Brazil.
Abstract
Background: Biological therapies have a significant economic and clinical burden but, in general, lose their effectiveness over time. This study evaluated the medication persistence and costs associated to use of anti-TNF agents for psoriatic arthritis (PsA) treatment. Methods: A historical cohort composed of individuals in Brazil with PsA diagnosis was developed during the period between 2010 and 2015. The difference among the anti-TNF agents was verified by the log-rank test. The predictors of medication non-persistence were identified by Cox regression. The costs were compared by variance analysis with Bonferroni correction. Results: 11,008 patients were analyzed. Adalimumab (51%) was the most used anti-TNF agent. Individuals using adalimumab presented higher medication persistence as compared to etanercept and infliximab. The costs with anti-TNF agents corresponded to 90% of the total costs and were similar among anti-TNF agents. The non-persistence predictors were female sex, younger patients, to live in the Northeastern and Northern regions of Brazil, to use infliximab and etanercept, and have more comorbidities. Conclusion: The direct costs with anti-TNF agents were the main component of total costs. Outpatient and inpatient costs increase when medication persistence decreases. A considerable price reduction of anti-TNF agents has been observed over the years.
Background: Biological therapies have a significant economic and clinical burden but, in general, lose their effectiveness over time. This study evaluated the medication persistence and costs associated to use of anti-TNF agents for psoriatic arthritis (PsA) treatment. Methods: A historical cohort composed of individuals in Brazil with PsA diagnosis was developed during the period between 2010 and 2015. The difference among the anti-TNF agents was verified by the log-rank test. The predictors of medication non-persistence were identified by Cox regression. The costs were compared by variance analysis with Bonferroni correction. Results: 11,008 patients were analyzed. Adalimumab (51%) was the most used anti-TNF agent. Individuals using adalimumab presented higher medication persistence as compared to etanercept and infliximab. The costs with anti-TNF agents corresponded to 90% of the total costs and were similar among anti-TNF agents. The non-persistence predictors were female sex, younger patients, to live in the Northeastern and Northern regions of Brazil, to use infliximab and etanercept, and have more comorbidities. Conclusion: The direct costs with anti-TNF agents were the main component of total costs. Outpatient and inpatient costs increase when medication persistence decreases. A considerable price reduction of anti-TNF agents has been observed over the years.
Authors: Ronaldo José Faria; Francisca Janiclecia Rezende Cordeiro; Jéssica Barreto Ribeiro Dos Santos; Juliana Alvares-Teodoro; Augusto Afonso Guerra Júnior; Francisco de Assis Acurcio; Michael Ruberson Ribeiro da Silva Journal: Front Pharmacol Date: 2022-04-26 Impact factor: 5.988
Authors: Ana F Souza; Michael R Da Silva; Jéssica B Dos Santos; Alessandra M Almeida; Francisco A Acurcio; Juliana Alvares-Teodoro Journal: Pharm Pract (Granada) Date: 2021-05-28