Evidence map›Paper›PMID 34751912›Full record

Observational studyAdvances in therapy2022

Health-Care and Societal Costs Associated with Non-Persistence with Subcutaneous TNF-α Inhibitors in the Treatment of Inflammatory Arthritis (IA): A Retrospective Observational Study.

Johan Dalén, Anushri Chitkara, Axel Svedbom, Tor Olofsson, Amy Puenpatom, Christopher M Black, Zaina P Qureshi

Erratum issuedOpen access · hybridAbstract readObservational Study
In one paragraph

Observational study in Advances in therapy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.5field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 3 countries.

Johan DalénICON Plc, Stockholm, Sweden.
Anushri ChitkaraICON Plc, Bangalore, India.
Axel SvedbomICON Plc, Stockholm, Sweden.
Tor OlofssonDepartment of Clinical Sciences Lund, Rheumatology, Lund University, Skåne University Hospital, Lund, Sweden.
Amy PuenpatomCenter for Observational and Real-World Evidence (CORE), Merck & Co., Inc., 2000 Galloping Hill Rd, Kenilworth, NJ, 07331, USA.
Christopher M BlackCenter for Observational and Real-World Evidence (CORE), Merck & Co., Inc., 2000 Galloping Hill Rd, Kenilworth, NJ, 07331, USA.
Zaina P QureshiCenter for Observational and Real-World Evidence (CORE), Merck & Co., Inc., 2000 Galloping Hill Rd, Kenilworth, NJ, 07331, USA. zaina.qureshi@merck.com.ORCID http://orcid.org/0000-0001-9605-3980
Merck & Co., Inc., Rahway, NJ, USA (United States) · USIcon (India) · INLund University · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveA few studies have suggested that patients with inflammatory arthritis (IA) who remain persistent with subcutaneous TNF-α inhibitors (SC-TNFi) incur lower health care costs than patients who discontinue treatment, whereas data on the impact of non-persistence on indirect costs are largely lacking. Furthermore, existing estimates are based on fixed follow-ups, in relation to treatment initiation, and therefore do not measure costs in direct relation to treatment discontinuation. Therefore, by capturing costs in direct relation to treatment discontinuation, this study aimed to estimate direct and indirect costs associated with non-persistence with SC-TNFis in IA.

methodsAdult Swedish biologic-naïve IA patients initiating biologic treatment with a SC-TNFi (adalimumab, etanercept, certolizumab or golimumab) between May 6, 2010, and December 31, 2017, were identified in population-based registers with almost complete coverage. IA was defined as a diagnosis of rheumatic arthritis, ankylosing spondylitis/unspecified spondyloarthritis or psoriatic arthritis. Non-persistent patients were matched on propensity score to patients persistent with treatment by at least an additional 12 months. This enabled comparisons of direct healthcare costs and indirect costs for sick leave and disability pension, respectively, 12 months before and 12 months after treatment discontinuation.

resultsA balanced cohort of 486 matched pairs was generated. The total direct and indirect costs were significantly higher among non-persistent patients already during the 12 months before index ($20,802 [18,335-23,429] vs. $16,600 [14,331-18,696]). However, while non-persistent patients increased their total direct and indirect costs, persistent patients significantly decreased the same, further widening the difference in costs during the 12-month period after index date ($22,161 [19,754-24,556] vs. $13,465 [11,415-15,729]).

conclusionsAmong biologic-naïve Swedish IA patients treated with SC-TNFis, persistent patients incurred about 40% lower aggregated direct and indirect costs compared to non-persistent patients the year following SC-TNFi discontinuation. This highlights the impact of treatment persistence from an economic viewpoint, adding further aspects to the clinical perspective.

Indexed as

Antirheumatic AgentsArthritis, PsoriaticArthritis, RheumatoidBiological ProductsSpondylitis, AnkylosingAdalimumabAdultEtanerceptHumansRetrospective StudiesTumor Necrosis Factor-alphaTumor Necrosis Factor InhibitorsAdalimumabAntirheumatic AgentsBiological ProductsEtanerceptTumor Necrosis Factor-alphaTumor Necrosis Factor InhibitorsAnkylosing spondylitisBiologicsPsoriatic arthritisRheumatoid arthritisSpondyloarthritisTreatment persistenceTumor necrosis factor-alpha inhibitors

Identifiers

PMID34751912
PMCPMC9122890
OpenAlexW3211894212

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.