Nearly half of BCBS members discontinue this RA drug after 1 year
Analysis from Prime shows that improvements in persistency, adherence is key in RA treatments.
Payers should develop care and utilization management programs that encourage adherence to the most cost effective rheumatoid arthritis (RA) treatments, according to new
Gleason
“Providers and payers should look for ways to improve persistency and consider outcomes-based contracts linked to adherence. These programs should emphasize use of a nonbiologic DMARD [disease-modifying antirheumatic drug] as first-line therapy,” study coauthor Pat Gleason, PharmD, director of health outcomes at Prime Therapeutic, told Managed Healthcare Executive.
Prime analyzed members’ use of RA drug tofacitinib (Xeljanz) to find patterns and adherence behaviors. Researchers integrated medical and pharmacy claims data for members from 12 Blue Cross and Blue Shield clients with a combined average commercially insured population of 13.8 million members per month.
Prime selected 4.4 million members with continuous enrollment from January 2012 through December 2015. Prior and concurrent DMARD assessment and persistency analysis were limited to Xeljanz users with an RA medical diagnosis.
“This allowed us to look at therapy one year prior to starting Xeljanz and to follow Xeljanz utilizers for an average of 16 months after starting their Xeljanz therapy,” Gleason said.
While use of the drug had been low, it is steadily increasing at a rate of 0.24 members per 100,000 commercially insured members per month, according to Gleason.
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