Cost of Care Higher for Patients With RA Using Biologic Treatment

Despite an expansion of treatment options with biologic disease-modifying antirheumatic drugs (bDMARDS) among patients with rheumatoid arthritis (RA), researchers recently found that the cost of bDMARDs is the primary driving factor for the cost of care among these patients. 

According to the research team, led by Andrew Hresko, MD, Tufts University School of Medicine, and colleagues, the costs for RA within Medicare remain poorly understood, despite the size of the patient population. The researchers said that bDMARDS have become an important part of care for patients with RA. 

“Greater insight into the detailed cost to Medicare for patients with RA would be valuable to both policymakers and health care providers, supporting planning for the allocation of limited resources,” Dr Hresko and colleagues said. 

To better understand the related costs, the researchers observed Medicare beneficiaries who were enrolled in the Brigham and Women’s Hospital Rheumatoid Arthritis Sequential Study. The cost and utilization data for inpatient admissions, outpatient care, and physician services were acquired from the Medicare Standard Analytics Files for 2006-2010. Further, prescription drug utilization data was obtained from the Prescription Drug Even File, which was based on Medicare Part D claims. 

The researchers identified 197 individuals who met inclusion criteria. This population contributed to a total of 435 patient years, the researchers noted. 

According to the findings, the mean annual direct cost of all medical care was $36,643. For RA-specific care, the researchers found that costs totaled $19,216, or 52% of total costs. Within RA-specific care, hospitalizations accounted for 6.3% of costs, outpatient care 25.6%, medications 67.3%, and post-acute care 0.9%. Although the research team noted that there was no significant difference in distribution of RA-specific costs across year, they said that RA-specific costs were dominated by costs of bDMARDs. They found that the mean annual cost for bDMARDs across the total study cohort was $12,167, representing 94.6% of RA-related drug costs and 63.6% of total RA-specific costs.

“While bDMARDs have expanded treatment options for RA patients, the cost of bDMARDs is the primary driving factor for the cost of RA-specific care,” Dr Hresko and colleagues concluded.

These findings were presented at the 2018 ACR/ARHP Annual Meeting.—Julie Gould