Drug utilization and medication adherence for the treatment of psoriatic arthritis: an Italian study.

IF 0.4 Q4 HEALTH CARE SCIENCES & SERVICES Global & Regional Health Technology Assessment Pub Date : 2024-10-09 eCollection Date: 2024-01-01 DOI:10.33393/grhta.2024.3204
Fiorenzo Santoleri, Paolo Abrate, Laura Pestrin, Enrico Pasut, Germana Modesti, Felice Musicco, Chiara Fulgenzio, Eva Zuzolo, Gabriella Pieri, Martina Roperti, Pietro Gazzola, Marco Gambera, Isabella Martignoni, Valentina Montresor, Francesca Guarino, Laura Grossi, Letizia Di Fabio, Cristina Roberti, Concetta Spoltore, Gabriella Tinari, Stefania De Rosa, Romina Giannini, Roberto Langella, Grazia Mingolla, Mariantonietta Piccoli, Alberto Costantini
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Abstract

Introduction: This study aims to evaluate the persistence, treatment adherence and drug cost associated with biologic and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) in the management of psoriatic arthritis (PsA) in Italy, with a focus on biosimilar drugs.

Methods: This was a retrospective observational study involving eight hospital pharmacies, between January 2017 and December 2020, on naïve patients with at least one b/tsDMARD dispensation indicated for PsA. Patients were followed up for 12 months and persistence and adherence were evaluated by proportion of days covered (PDC). The originator and biosimilar for adalimumab and etanercept were compared. Furthermore, the real annual cost per patient based on adherence to therapy was calculated.

Results: Patients initiating b/tsDMARDs for PsA had a mean persistence of 263 days and 48.6% remained persistent for 1 year. Adherent patients (PDC ≥ 0.8) were 47.6% for the overall population. Similar persistence and adherence were observed between patients treated with the adalimumab originator and its biosimilar, while patients treated with the etanercept originator showed lower persistence and adherence compared to those treated with its biosimilar (mean persistence: 222 vs. 267 days, patient persistent at 1 year: 29.4% vs. 51.5%, mean PDC: 0.53 vs. 0.70, adherent patients: 23.5% vs. 51.5%). The average annual drug cost ranged from €8,724 (etanercept) to €14,783 (ustekinumab), with an annual saving of more than €2,500 by using biosimilars.

Conclusion: Poor adherence to medications contributes to suboptimal clinical outcomes. The comparison between biosimilar and originator offers further evidence in support of the biosimilar to optimizing resources in healthcare.

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治疗银屑病关节炎的药物使用和用药依从性:一项意大利研究。
简介:本研究旨在评估意大利银屑病关节炎(PsA)治疗中与生物制剂和靶向合成改善病情抗风湿药(b/tsDMARDs)相关的持续性、治疗依从性和药物成本,重点是生物类似药:这是一项回顾性观察研究,涉及 8 家医院药房,研究时间为 2017 年 1 月至 2020 年 12 月,研究对象为至少有一种 b/tsDMARD 配药适用于 PsA 的新患者。对患者进行了为期 12 个月的随访,并通过覆盖天数比例(PDC)评估了患者的持续性和依从性。比较了阿达木单抗和依那西普的原研药和生物仿制药。此外,还计算了基于治疗依从性的每位患者每年的实际成本:结果:开始使用b/tsDMARDs治疗PsA的患者平均坚持治疗263天,48.6%的患者坚持治疗1年。坚持治疗的患者(PDC ≥ 0.8)占总人数的 47.6%。接受阿达木单抗原研药及其生物类似药治疗的患者的持续率和依从性相似,而接受依那西普原研药治疗的患者的持续率和依从性低于接受其生物类似药治疗的患者(平均持续率:222天 vs. 267天,1年持续率:29.4% vs. 51.4%):29.4% 对 51.5%,平均 PDC:0.53 对 0.70,坚持治疗的患者:23.5% 对 51.5%:23.5%对51.5%)。每年的平均药物成本从8724欧元(依那西普)到14783欧元(乌司替吉单抗)不等,使用生物仿制药每年可节省超过2500欧元:结论:用药依从性差会导致临床疗效不理想。生物仿制药与原研药之间的比较进一步证明,生物仿制药可以优化医疗资源。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Global & Regional Health Technology Assessment
Global & Regional Health Technology Assessment HEALTH CARE SCIENCES & SERVICES-
CiteScore
0.80
自引率
20.00%
发文量
27
审稿时长
8 weeks
期刊介绍: Global & Regional Health Technology Assessment (GRHTA) is a peer-reviewed, open access journal which aims to promote health technology assessment and economic evaluation, enabling choices among alternative therapeutical paths or procedures with different clinical and economic outcomes. GRHTA is a unique journal having three different editorial boards who focus on their respective geographical expertise.
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