Cargando…

Drug-Utilization, Healthcare Facilities Accesses and Costs of the First Generation of JAK Inhibitors in Rheumatoid Arthritis

This study is aimed at describing tofacitinib and baricitinib users by characterizing their prescription and healthcare histories, drug and healthcare utilization patterns, and direct costs from a healthcare system perspective. This retrospective cohort study was performed using Tuscan administrativ...

Descripción completa

Detalles Bibliográficos
Autores principales: Convertino, Irma, Lorenzoni, Valentina, Gini, Rosa, Turchetti, Giuseppe, Fini, Elisabetta, Giometto, Sabrina, Bartolini, Claudia, Paoletti, Olga, Ferraro, Sara, Cappello, Emiliano, Valdiserra, Giulia, Bonaso, Marco, Blandizzi, Corrado, Tuccori, Marco, Lucenteforte, Ersilia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10058541/
https://www.ncbi.nlm.nih.gov/pubmed/36986565
http://dx.doi.org/10.3390/ph16030465
_version_ 1785016656566681600
author Convertino, Irma
Lorenzoni, Valentina
Gini, Rosa
Turchetti, Giuseppe
Fini, Elisabetta
Giometto, Sabrina
Bartolini, Claudia
Paoletti, Olga
Ferraro, Sara
Cappello, Emiliano
Valdiserra, Giulia
Bonaso, Marco
Blandizzi, Corrado
Tuccori, Marco
Lucenteforte, Ersilia
author_facet Convertino, Irma
Lorenzoni, Valentina
Gini, Rosa
Turchetti, Giuseppe
Fini, Elisabetta
Giometto, Sabrina
Bartolini, Claudia
Paoletti, Olga
Ferraro, Sara
Cappello, Emiliano
Valdiserra, Giulia
Bonaso, Marco
Blandizzi, Corrado
Tuccori, Marco
Lucenteforte, Ersilia
author_sort Convertino, Irma
collection PubMed
description This study is aimed at describing tofacitinib and baricitinib users by characterizing their prescription and healthcare histories, drug and healthcare utilization patterns, and direct costs from a healthcare system perspective. This retrospective cohort study was performed using Tuscan administrative healthcare databases, which selected two groups of Janus kinase inhibitors (JAKi) incident users (index date) from 1st January 2018 to 31 December 2019 and from 1 January 2018 to 30 June 2019. We included patients ≥18 years old, at least 10 years of data, and six months of follow-up. In the first analysis, we describe mean time, standard deviation (SD), from the first-ever disease-modifying antirheumatic drug (DMARD) to the JAKi, and costs of healthcare facilities and drugs in the 5 years preceding the index date. In the second analysis, we assessed Emergency Department (ED) accesses and hospitalizations for any causes, visits, and costs in the follow-up. In the first analysis, 363 incident JAKi users were included (mean age 61.5, SD 13.6; females 80.7%, baricitinib 78.5%, tofacitinib 21.5%). The time to the first JAKi was 7.2 years (SD 3.3). The mean costs from the fifth to the second year before JAKi increased from 4325 € (0; 24,265) to 5259 € (0; 41,630) per patient/year, driven by hospitalizations. We included 221 incident JAKi users in the second analysis. We observed 109 ED accesses, 39 hospitalizations, and 64 visits. Injury and poisoning (18.3%) and skin (13.8%) caused ED accesses, and cardiovascular (69.2%) and musculoskeletal (64.1%) caused hospitalizations. The mean costs were 4819 € (607.5; 50,493) per patient, mostly due to JAKi. In conclusion, the JAKi introduction in therapy occurred in compliance with RA guidelines and the increase in costs observed could be due to a possible selective prescription.
format Online
Article
Text
id pubmed-10058541
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-100585412023-03-30 Drug-Utilization, Healthcare Facilities Accesses and Costs of the First Generation of JAK Inhibitors in Rheumatoid Arthritis Convertino, Irma Lorenzoni, Valentina Gini, Rosa Turchetti, Giuseppe Fini, Elisabetta Giometto, Sabrina Bartolini, Claudia Paoletti, Olga Ferraro, Sara Cappello, Emiliano Valdiserra, Giulia Bonaso, Marco Blandizzi, Corrado Tuccori, Marco Lucenteforte, Ersilia Pharmaceuticals (Basel) Article This study is aimed at describing tofacitinib and baricitinib users by characterizing their prescription and healthcare histories, drug and healthcare utilization patterns, and direct costs from a healthcare system perspective. This retrospective cohort study was performed using Tuscan administrative healthcare databases, which selected two groups of Janus kinase inhibitors (JAKi) incident users (index date) from 1st January 2018 to 31 December 2019 and from 1 January 2018 to 30 June 2019. We included patients ≥18 years old, at least 10 years of data, and six months of follow-up. In the first analysis, we describe mean time, standard deviation (SD), from the first-ever disease-modifying antirheumatic drug (DMARD) to the JAKi, and costs of healthcare facilities and drugs in the 5 years preceding the index date. In the second analysis, we assessed Emergency Department (ED) accesses and hospitalizations for any causes, visits, and costs in the follow-up. In the first analysis, 363 incident JAKi users were included (mean age 61.5, SD 13.6; females 80.7%, baricitinib 78.5%, tofacitinib 21.5%). The time to the first JAKi was 7.2 years (SD 3.3). The mean costs from the fifth to the second year before JAKi increased from 4325 € (0; 24,265) to 5259 € (0; 41,630) per patient/year, driven by hospitalizations. We included 221 incident JAKi users in the second analysis. We observed 109 ED accesses, 39 hospitalizations, and 64 visits. Injury and poisoning (18.3%) and skin (13.8%) caused ED accesses, and cardiovascular (69.2%) and musculoskeletal (64.1%) caused hospitalizations. The mean costs were 4819 € (607.5; 50,493) per patient, mostly due to JAKi. In conclusion, the JAKi introduction in therapy occurred in compliance with RA guidelines and the increase in costs observed could be due to a possible selective prescription. MDPI 2023-03-21 /pmc/articles/PMC10058541/ /pubmed/36986565 http://dx.doi.org/10.3390/ph16030465 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Convertino, Irma
Lorenzoni, Valentina
Gini, Rosa
Turchetti, Giuseppe
Fini, Elisabetta
Giometto, Sabrina
Bartolini, Claudia
Paoletti, Olga
Ferraro, Sara
Cappello, Emiliano
Valdiserra, Giulia
Bonaso, Marco
Blandizzi, Corrado
Tuccori, Marco
Lucenteforte, Ersilia
Drug-Utilization, Healthcare Facilities Accesses and Costs of the First Generation of JAK Inhibitors in Rheumatoid Arthritis
title Drug-Utilization, Healthcare Facilities Accesses and Costs of the First Generation of JAK Inhibitors in Rheumatoid Arthritis
title_full Drug-Utilization, Healthcare Facilities Accesses and Costs of the First Generation of JAK Inhibitors in Rheumatoid Arthritis
title_fullStr Drug-Utilization, Healthcare Facilities Accesses and Costs of the First Generation of JAK Inhibitors in Rheumatoid Arthritis
title_full_unstemmed Drug-Utilization, Healthcare Facilities Accesses and Costs of the First Generation of JAK Inhibitors in Rheumatoid Arthritis
title_short Drug-Utilization, Healthcare Facilities Accesses and Costs of the First Generation of JAK Inhibitors in Rheumatoid Arthritis
title_sort drug-utilization, healthcare facilities accesses and costs of the first generation of jak inhibitors in rheumatoid arthritis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10058541/
https://www.ncbi.nlm.nih.gov/pubmed/36986565
http://dx.doi.org/10.3390/ph16030465
work_keys_str_mv AT convertinoirma drugutilizationhealthcarefacilitiesaccessesandcostsofthefirstgenerationofjakinhibitorsinrheumatoidarthritis
AT lorenzonivalentina drugutilizationhealthcarefacilitiesaccessesandcostsofthefirstgenerationofjakinhibitorsinrheumatoidarthritis
AT ginirosa drugutilizationhealthcarefacilitiesaccessesandcostsofthefirstgenerationofjakinhibitorsinrheumatoidarthritis
AT turchettigiuseppe drugutilizationhealthcarefacilitiesaccessesandcostsofthefirstgenerationofjakinhibitorsinrheumatoidarthritis
AT finielisabetta drugutilizationhealthcarefacilitiesaccessesandcostsofthefirstgenerationofjakinhibitorsinrheumatoidarthritis
AT giomettosabrina drugutilizationhealthcarefacilitiesaccessesandcostsofthefirstgenerationofjakinhibitorsinrheumatoidarthritis
AT bartoliniclaudia drugutilizationhealthcarefacilitiesaccessesandcostsofthefirstgenerationofjakinhibitorsinrheumatoidarthritis
AT paolettiolga drugutilizationhealthcarefacilitiesaccessesandcostsofthefirstgenerationofjakinhibitorsinrheumatoidarthritis
AT ferrarosara drugutilizationhealthcarefacilitiesaccessesandcostsofthefirstgenerationofjakinhibitorsinrheumatoidarthritis
AT cappelloemiliano drugutilizationhealthcarefacilitiesaccessesandcostsofthefirstgenerationofjakinhibitorsinrheumatoidarthritis
AT valdiserragiulia drugutilizationhealthcarefacilitiesaccessesandcostsofthefirstgenerationofjakinhibitorsinrheumatoidarthritis
AT bonasomarco drugutilizationhealthcarefacilitiesaccessesandcostsofthefirstgenerationofjakinhibitorsinrheumatoidarthritis
AT blandizzicorrado drugutilizationhealthcarefacilitiesaccessesandcostsofthefirstgenerationofjakinhibitorsinrheumatoidarthritis
AT tuccorimarco drugutilizationhealthcarefacilitiesaccessesandcostsofthefirstgenerationofjakinhibitorsinrheumatoidarthritis
AT lucenteforteersilia drugutilizationhealthcarefacilitiesaccessesandcostsofthefirstgenerationofjakinhibitorsinrheumatoidarthritis