Background: The first JAK inhibitor (JAKi) was approved for rheumatoid arthritis (RA) in late 2018. Objectives: This study aims at describing the pattern of direct healthcare costs among new JAKi users before and after the first JAKi dispensation using administrative healthcare databases. Methods: Using the Tuscan administrative healthcare databases we retrospectively identified adult patients new JAKi users with at least 10 years of look back period. We estimated direct healthcare costs associated with emergency department (ED) accesses, hospitalizations (H), RA visits (RV) and DMARDs dispensation for each of the 5 years preceding the first JAKi dispensation on the basis of healthcare resource use and the overall economic impact on the budget of the regional healthcare system (RHS) in a cohort of patients having received the first dispensation from January 1st, 2018 to December 31st, 2019 (cohort 1); in a second cohort of patients (cohort 2) receiving the first JAKi dispensation between 1st, 2018 to June 30th, 2019 with at least 6 months follow after treatment initiation we also evaluated direct healthcare costs following the first JAKi dispensation. Results: Cohort 1 included 363 new JAKi users (mean age 61.5 ±13.6 years, 80.7% females) with a first prescription of baricitinib (78.5%) or tofacitinib (21.5%). In this cohort we observed a slightly increase in mean direct costs from the 5th to the 2nd year preceding the first JAKi prescription: from 4,325€ (0;24,265) per patient/year to 5,259€ (0;41,630) per patient/year and the increase was related to a significant increase in the costs associated with hospitalizations, despite the incidence of events remained quite invariant. Accordingly, the overall costs born to the RHS and associated with patients highlighted a slightly increase from 1,569,855€ to 1,909,106€ respectively from the 5th to the 2nd year before the first JAKi dispensation. Cohort 2 included 220 new JAKi users with characteristics similar to those observed for cohort 1. In cohort 2 the pattern of costs in the look back period was similar to what observed for cohort 1, while mean costs in the six months following the first JAKi prescription were 4,819€ (607.5;50,493) per patient, 84% of which were attributable to JAKi. Conclusions: Findings from the present study highlighted a progressive increase of direct health costs in the 5 years preceding the treatment with JAKi that is likely to be related to increasing clinical relevance of causes for resources use. The increase of costs observed after the introduction of JAKi is leaded by the higher acquisition cost of drugs while other costs items seemed to remain unaltered.
Direct health care costs among patients with rheumatoid arthritis before and after the initiation of treatment with JAKi in Tuscany: The LEONARDO study
Lorenzoni, V;Tuccori, M;Fini, E;Convertino, I;Ferraro, S;Cappello, E;Valdiserra, G;Blandizzi, C;Lucenteforte, E;Turchetti, G
2021-01-01
Abstract
Background: The first JAK inhibitor (JAKi) was approved for rheumatoid arthritis (RA) in late 2018. Objectives: This study aims at describing the pattern of direct healthcare costs among new JAKi users before and after the first JAKi dispensation using administrative healthcare databases. Methods: Using the Tuscan administrative healthcare databases we retrospectively identified adult patients new JAKi users with at least 10 years of look back period. We estimated direct healthcare costs associated with emergency department (ED) accesses, hospitalizations (H), RA visits (RV) and DMARDs dispensation for each of the 5 years preceding the first JAKi dispensation on the basis of healthcare resource use and the overall economic impact on the budget of the regional healthcare system (RHS) in a cohort of patients having received the first dispensation from January 1st, 2018 to December 31st, 2019 (cohort 1); in a second cohort of patients (cohort 2) receiving the first JAKi dispensation between 1st, 2018 to June 30th, 2019 with at least 6 months follow after treatment initiation we also evaluated direct healthcare costs following the first JAKi dispensation. Results: Cohort 1 included 363 new JAKi users (mean age 61.5 ±13.6 years, 80.7% females) with a first prescription of baricitinib (78.5%) or tofacitinib (21.5%). In this cohort we observed a slightly increase in mean direct costs from the 5th to the 2nd year preceding the first JAKi prescription: from 4,325€ (0;24,265) per patient/year to 5,259€ (0;41,630) per patient/year and the increase was related to a significant increase in the costs associated with hospitalizations, despite the incidence of events remained quite invariant. Accordingly, the overall costs born to the RHS and associated with patients highlighted a slightly increase from 1,569,855€ to 1,909,106€ respectively from the 5th to the 2nd year before the first JAKi dispensation. Cohort 2 included 220 new JAKi users with characteristics similar to those observed for cohort 1. In cohort 2 the pattern of costs in the look back period was similar to what observed for cohort 1, while mean costs in the six months following the first JAKi prescription were 4,819€ (607.5;50,493) per patient, 84% of which were attributable to JAKi. Conclusions: Findings from the present study highlighted a progressive increase of direct health costs in the 5 years preceding the treatment with JAKi that is likely to be related to increasing clinical relevance of causes for resources use. The increase of costs observed after the introduction of JAKi is leaded by the higher acquisition cost of drugs while other costs items seemed to remain unaltered.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
