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. 2012 Sep;125(9):937.e9-15.
doi: 10.1016/j.amjmed.2011.11.014. Epub 2012 Jun 9.

Time trends in medication use and expenditures in older patients with rheumatoid arthritis

Leslie R Harrold  1 , Daniel Peterson, Ashley J Beard, Jerry H Gurwitz, Becky A Briesacher
Affiliations

Time trends in medication use and expenditures in older patients with rheumatoid arthritis

Leslie R Harrold et al. Am J Med. 2012 Sep.

Abstract

Background: We sought to examine how expansions in insurance coverage of nonbiologic and biologic disease-modifying antirheumatic drugs affected the access, costs, and health status of older patients with rheumatoid arthritis.

Methods: We identified a nationally representative sample of older adults with rheumatoid arthritis in the 2000-2006 Medicare Current Beneficiary Survey (unweighted n=1051). We examined changes in disease-modifying antirheumatic drug use, self-reported health status, functional status (activities of daily living), and total costs and out-of-pocket costs for medical care and prescription drugs. Tests for time trends were conducted using weighted regressions.

Results: Between 2000 and 2006, the proportion of older adults with rheumatoid arthritis who received biologics tripled (4.6% vs 13.2%, P=.01), whereas the proportion of people who used a nonbiologic did not change. During the same period, the proportion of older patients with rheumatoid arthritis rating their health as excellent/good significantly increased (43.0% in 2000 to 55.6% in 2006; P=.015). Significant improvements occurred in activities of daily living measures of functional status. Total prescription drug costs (in 2006 US dollars) increased from $2645 in 2000 to $4685 in 2006, P=.0001, whereas out-of-pocket prescription costs remained constant ($842 in 2000 vs $832 in 2006; P=.68). Total medical costs did not significantly increase ($16,563 in 2000 vs $19,510 in 2006; P=.07).

Conclusion: Receipt of biologics in older adults with rheumatoid arthritis increased over a period of time when insurance coverage was expanded without increasing patients' out-of-pocket costs. During this time period, concurrent improvements in self-reported health status and functional status suggest improved arthritis care.

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Conflict of interest statement

Conflict of Interest Statement:

All authors have no conflict of interest to disclose.

All authors had access to the data and a role in writing the manuscript.

Figures

Figure 1
Figure 1
Time trends in the use of biologics and functional status, 2000–2006.* *RA = Rheumatoid Arthritis; ADL = Acitivities of Daily Living
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