ArticleDrugs & therapy perspectives : for rational drug selection and use2026
Differences in time to drug initiation and inactive disease achievement by insurance type in patients with nonsystemic juvenile idiopathic arthritis.
Article in Drugs & therapy perspectives : for rational drug selection and use, 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
Introduction: Juvenile idiopathic arthritis (JIA) is a chronic autoimmune condition that can lead to significant complications if not promptly managed. Current guidelines recommend biologic or targeted synthetic disease modifying antirheumatic drugs (b/tsDMARDs) as part of the treatment algorithm. In the USA, patients are covered by a wide range of insurance plans that can be broadly classified into two categories-public or private. The influence of insurance type on access to JIA therapies and subsequent outcomes remains poorly understood. The objective of this study was to investigate how b/tsDMARD initiation and achievement of clinically inactive disease (CID) may differ by insurance type in patients with nonsystemic forms of JIA. Methods: Patients newly diagnosed with JIA according to International League of Associations (ILAR) for Rheumatology classification criteria between 2009 and 2020 at a large tertiary center were studied. Outcome variables of time to b/tsDMARD initiation and time to CID of JIA were assessed. Descriptive statistics were performed, and patients with public or private insurance were compared cross-sectionally and over the study timeframe using survival analysis. Results: There were 968 patients with newly diagnosed JIA during the study period; 753 (78%) were privately insured and 215 (22%) were publicly insured. During 5898 patient-years of follow-up, 562 (58%) patients initiated b/tsDMARDs and 677 (70%) patients achieved CID. Time to b/tsDMARD initiation did not differ by insurance type (both approximately 5 months, Conclusion: While time to b/tsDMARD initiation was similar across insurance groups, publicly insured patients achieved CID later than privately insured patients. These findings may be interpreted as insurance-associated differences. Additional studies are needed to clarify the roles of baseline disease severity, healthcare access, adherence, and socioeconomic context factors. Supplementary Information: The online version contains supplementary material available at 10.1007/s40267-026-01241-0.
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