August 23, 2017
A support program designed to assist patients treated with adalimumab (Humira; AbbVie) was associated with greater adherence, improved persistence, and reduced all-cause and disease-related medical and total health care costs, according to the results of a recent study by Rubin and colleagues, published in the Journal of Managed Care & Specialty Pharmacy.1
The free-to-patients support program is designed to assist adalimumab-treated patients with medication costs, nurse support, injection training, pen disposal, and medication reminders.
The researchers conducted a longitudinal, retrospective, cohort study to quantify the relationship between participation in the support program and outcomes in treated patients. The study used patient-level data from the support program combined with Symphony Health Solutions administrative claims data for patients initiating adalimumab between January 2008 and June 2 014. The researchers of the study observed patients aged ≥ 18 years with a diagnosis of Crohn disease, ulcerative colitis, rheumatoid arthritis, psoriasis, psoriatic arthritis, or ankylosing spondylitis who were biologic-naïve before initiation of adalimumab.
Biologics Before Triple Therapy May Not Be Cost-Effective for RA
AbbVie's Rheumatoid Arthritis Drug Succeeds in Late-Stage Trial
To determine the outcomes of program participation, researchers compared adherence (proportion of days covered during the 12 months following support program opt-in [index date]) between 2 study cohorts—patients enrolled in the support program and patients not enrolled—using t-tests. Persistence was assessed using survival analysis of discontinuation rates. Further, medical costs for emergency department, inpatient, physician, and outpatient visits and total costs (medical plus drug costs) were compared at 12 months following the index date using t-tests.
The study researchers observed 2386 participants who were allocated to the enrolled support program cohort (n=1199) and non-enrolled support program cohort (n=1187), and found similar baseline characteristics between the cohorts. During the follow-up, adalimumab adherence was 14% greater in the enrolled support group cohort than for the non-enrolled cohort (67.0% vs. 58.8%; P<0.001). Additionally, discontinuation rates for adalimumab was 14% lower for patients enrolled in a support program compared to non-enrolled patients (39.7% vs. 46.2%; P = 0.001).
The study used univariate analyses and found that support program patients had 23% lower 12-month medical costs (excluding costs for biologic treatment) than did non-enrolled patients ($18,322 vs. $23,679; P=0.003). Further, disease-related medical costs were 22% lower for support program patients ($8,001 vs. $10,202; P= 0.045), and the overall total costs were 10% lower for enrolled patients ($35,741 vs. $39,713; P = 0.030).
“These data provide support for prescribing physicians to encourage enrollment in patient support programs for inflammatory conditions and for pharmaceutical companies to further develop and invest in multifaceted patient support programs,” concluded the authors.
—Julie Gould (Mazurkiewicz)
Rubin DT, Mittal M, Davis M, et al. Impact of a Patient Support Program on Patient Adherence to Adalimumab and Direct Medical Costs in Crohn’s Disease, Ulcerative Colitis, Rheumatoid Arthritis, Psoriasis, Psoriatic Arthritis, and Ankylosing Spondylitis [published online August 2017]. J Manag Care Spec Pharm. 2017 Aug;23(8):859-867. doi: 10.18553/jmcp.2017.16272.