Comparison of Biologic Therapies for RA

San Antonio—A study of biologic therapies for rheumatoid arthritis (RA) examined the impact of clinical, demographic, socioeconomic, or behavioral characteristics difference among patients prescribed adalimumab, etanercept, or golimumab. L.A. Ellis and colleagues presented the study’s findings during a poster session at the AMCP meeting. The poster was titled Demographic and Clinical Characteristics of Patients Before Enrolling on Adalimumab, Etanercept or Golimumab.

This study included patients aged ≥18 years in the Optum Insight Clinformatics dataset. Eligible participants had claims for ≥60 day supply of their assigned biologic medication, ≥2 claims with an RA diagnosis, and ≥24 months of continuous medical and pharmacy eligibility. Study participants were then categorized into 1 of the 3 biologic groups based on the biologic on record closest to the end of the enrollment period, which was January 1, 2009, through March 31, 2011. In the year prior to the index date, demographic and clinical characteristics and healthcare costs were compared across the 3 groups. A total of 5737 individuals were included in the study—2222 were in the adalimumab group, 3168 were in the etanercept group, and the remaining 347 were in the golimumab group.

The pre-index demographic and clinical characteristics recorded showed differences among the 3 groups. The golimumab group had a higher proportion of female patients compared to the other 2 groups, and they were younger than the etanercept group (P<.05). A higher proportion of the golimumab group had prior biologic medication use (P<.001). The golimumab group also had a higher diagnosis of cerebrovascular disease, osteoarthritis, hypertension, depression, and chronic pain (P<.05). Additionally, a higher proportion of the golimumab group had prior experience with multiple biologics, compared to the other 2 groups.

The RA-specific healthcare costs 1 year prior to index were $14,021 for etanercept, $14,631 for adalimumab, and $18,691 for golimumab (P<.001). The non-RA healthcare costs 1 year prior to the index date were $16,823 for etanercept, $16,963 for adalimumab, and $25,241 for golimumab.

Overall, the golimumab group was younger, less healthy, and incurred greater total healthcare costs compared with the other 2 groups. The authors of the study note that these findings suggest future studies that make direct treatment comparisons should look into pre-index disease severity and other indicators that could influence the study results. Research methods adjusting for patient differences should be used when studying overall drug utilization patterns, healthcare costs, or comparative effectiveness between different therapies.

This research was supported by Janssen Scientific Affairs, LLC.