ArticleClinicoEconomics and outcomes research : CEOR2026
Adherence to Acthar Gel (RCI) and Outcomes in Patients with Membranous Nephropathy: A Claims Database Analysis.
Article in ClinicoEconomics and outcomes research : CEOR, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: To describe real-world patient characteristics and outcomes after initiation of Acthar Gel (repository corticotropin injection, RCI) in the management of nephrotic syndrome (NS). This real-world study characterized patients with membranous nephropathy (MN) who initiated RCI therapy and evaluated the impact of higher versus lower adherence to RCI on NS-related outcomes, healthcare resource utilization, and medical costs. Patients and Methods: We retrospectively analyzed data from the Integrated Dataverse from Symphony Health database. Adult (≥18 years) patients were included if they had ≥1 inpatient or ≥2 outpatient claims for an NS and MN diagnosis (January 1, 2016-December 31, 2022); ≥1 prescription claim for RCI; and continuous eligibility ≥12 months before and ≥12 months following and including the index date. Patients with ≥2 RCI claims and a calculated proportion of days covered (PDC) were included. Those with a PDC above the sample mean were classified as "above-average" adherence and those below the mean as "below-average" adherence in that period. Results: The analyzed population comprised 28 patients with below-average and 34 with above-average RCI adherence. The above-average adherence cohort showed a noticeable reduction compared with the below-average adherence cohort in corticosteroid use, extended corticosteroid use, opioid use, NS-related renal biopsy procedures, all-cause and NS-related inpatient hospitalizations, and NS-related office visits. From baseline to follow-up, inpatient hospitalization rates were similar in the below-average adherence cohort for all-cause (50.0% vs 53.6%) and NS-related (35.7% vs 28.6%) admissions but markedly lower in the above-average cohort for all-cause (50.0% vs 23.5%) and NS-related (41.2% vs 8.8%) hospitalizations. Despite similar baseline medical costs, all-cause ($131,306 vs $50,048) and NS-related costs ($111,743 vs $29,868) were noticeably higher at follow-up in the below-average adherence cohort than the above-average adherence cohort. Conclusion: This real-world study shows that greater adherence to RCI during treatment improves overall outcomes studied.
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