PMS60 - THE IMPACT OF ADHERENCE TO BIOLOGIC AGENTS ON HEALTH CARE RESOURCE UTILIZATION FOR PATIENTS WITH RHEUMATOID ARTHRITIS

Abstract

Poor adherence to therapy increases the burden and complexity of chronic diseases such as rheumatoid arthritis (RA). In the past 15 years, biologics have revolutionized the treatment of RA. However, little data is available on impact of adherence to biologics on health-care resources. As part of a pilot project at the Institute for Clinical Evaluative Sciences (ICES), analyses were performed by ICES scientists on ICES administrative data to study the research question provided by Janssen Inc. Note, the approach and methodological details were determined by Janssen researchers. Patients were identified from the Ontario RA Database which contains all Ontario RA patients identified since 1991. Study population included RA patients, age 65+, with a prescription for a biologic drug between January 1, 2003 and December 31, 2013. Exclusion criteria are diagnosis of inflammatory bowel disease, psoriatic arthritis or psoriasis in the 5 years prior to the index event and discontinuation of biologic drug during the 12 months after the index event. Adherence was defined as a Medication Possession Ratio (MPR) of ≥0.8 measured as the proportion of days for which a patient had biologic treatment(s) over a defined follow-up period. Adherent were matched to non-adherent patients on a propensity score calculated using eight variables. A total of 4,667 RA patients were identified, of which 2,196 were deemed adherent and 2,471 non-adherent. The age (SD) was 69.9 (5.46) years and 75% were female. Relative rates for resource use (GP and cardiologist visits, ED visits, hospitalization, home care and rehabilitation) for the matched cohort were significantly lower (p<0.0001) in adherent patients. 67% of non-adherent patients used oral prednisone which is significantly higher (p<0.001) than 54% in the adherent cohort. RA patients who are adherent to biologic therapy have lower resource use and lower steroid used compared to non-adherent patients.