GHP April 2016

ghp April 2016 | 47 Research & Development score matched (PSM) cohorts, attempting to adjust for potential selection bias. Effects of non-persistence on healthcare resource utilisation (HCRU) costs A secondary objective of the study was to describe po- tential effects on HCRU cost from non-persistence.1 The analysis of costs was carried out on a subset of patients with at least 24 months of follow-up (i.e., patients initiating treatment prior to 1st January 2012; n= 3,120) and stratified by persistence status at 12 months’ post-treatment initiation.1 Patients who were persistent at 12 months incurred lower non-DMARD HCRU costs than patients who were not persistent over the same period, with an av- erage of 1,574 Euros (1,780 US Dollars]; p < 0.001) higher costs for non-persistent patients when taking differences in costs prior to treatment initiation into account.1 “This is thought to be the first study in a European setting that shows that persistence in treatment with SC-TNFi may be associated with cost offsets,” explains Sumesh Kachroo. “This provides further evidence for the need of an all-inclusive approach involving pro- vider-patient-payer-drug manufacturer to find ways to increase persistence rates in real-world settings”. About the Swedish Registry Publication The Swedish Registry Publication reports the findings of a retrospective analysis of data collected in a prescription registry. It evaluates real-world persis- tence with subcutaneous tumor necrosis factor-alpha inhibitors in SC-TNFi-naïve patients with ankylosing spondylitis, psoriatic arthritis and rheumatoid arthritis in Sweden. The secondary objective of the study was to describe potential effects on health care resource utilisation (HCRU) cost from non-persistence.1 A strength of this study is the size and coverage of the data.1 However, the study does have limitations. One is that the data obtained were extracted from admin- istrative databases, which are reliant on the quality of the coding and do not contain clinical measures, such as Health Assessment Questionnaire or Disease Activity Score 28; as a result, reasons for discontinu- ation with treatment cannot be determined. Another limitation is the register does not include information on dosage or actual consumption of medicine, so the persistence analysis relies on assumptions regarding treatment use.1 Patients included in this study were identified through filled prescriptions for adalimumab, etanercept, certolizumab pegol, and golimumab between 6th May 2010 and 31st December 2012 from the Swedish Prescribed Drug Register. Persistence was estimated using survival analysis. Costs were derived from HCRU and comprised specialised outpatient care, inpatient care and non-disease-modifying antirheumatic drug medications. A total of 4903 patients were identified and remained in the final study sample (ADA: 1823, ETA: 1704, CZP: 622, GLM: 754).1 Comparisons over 3 years showed that golimumab had significantly higher persistence than ADA (p = 0.022) and ETA (p = 0.004). The mean difference in non-biologic HCRU costs between persistent and non-persistent patients was higher after compared to before the start of biologic therapy. SC-TNFi-naïve IMRD patients initiating treatment with golimumab had significantly higher persistence rates than patients initiating treatment with ADA or ETA in Sweden.1 This study was funded by MSD (Merck & Co., Inc., Rahway, NJ, USA), who were involved with the writing, study design, analysis, and interpretation of data. About Rheumatoid Arthritis Rheumatoid arthritis is a chronic inflammatory dis- order that occurs when the immune system attacks the lining of the membranes that surround joints, also known as the synovium. Unlike the wear-and- tear damage associated with other types of arthritis, rheumatoid arthritis causes painful swelling and can eventually result in bone erosion and joint deformity. Rheumatoid arthritis can be difficult to diagnose in its initial stages because the early signs and symptoms mimic those of many other diseases. Currently, there is no single blood test or physical finding to confirm the diagnosis.4 It is estimated that 0.3 to 1 percent of the world’s population are living with rheumatoid arthritis. The disease is most common in women and is more prevalent in developed countries. It tends to strike during the most productive years of adulthood, between the ages of 20 and 40.5 About Psoriatic Arthritis Psoriatic arthritis, a type of inflammation that occurs in about 15 percent of patients who have a skin rash called psoriasis, is a chronic arthritis that can lead to joint damage.6 Psoriatic arthritis can affect any joint in the body, and it may affect just one joint, several joints or multiple joints. It typically affects the large joints, especially those of the lower extremities, distal joints of the fingers and toes, and also can affect the back and sacroiliac joints of the pelvis.6 Psoriatic arthritis symptoms flare and subside, vary from person to person, and even change locations in the same person over time.6 Both men and women are equally affected by psori- atic arthritis, most commonly between the ages of 30 and 50.6 About Ankylosing Spondylitis Axial spondyloarthritis is a painful and potentially pro- gressive form of inflammatory arthritis that mainly af- fects the spine and pelvic joints, and most commonly results in chronic lower back pain.7 It typically begins in the late teens and early twenties and in severe cases can result in complete fusion of the spinal ver- tebrae and cause structural damage to hips and other joints.7 The term axial spondyloarthritis covers both non-radiographic axial spondyloarthritis and ankylos- ing spondylitis.8 In patients with ankylosing spondylitis x-ray changes are clearly present.8 Axial spondyloarthritis is a systemic inflammatory disease that, in addition to its effect on the spine, can affect other areas such as peripheral joints, eyes, and the bowel.7 About Simponi Simponi (golimumab) is a human monoclonal anti- body that targets and neutralises tumor necrosis factor (TNF)-alpha. Simponi is approved for the treatment