Treatment patterns and costs ofpatients with ankylosing spondylitisinitiating biologic therapy in taiwan ??? apopulation-based analysis

Objective: To evaluate the real-world treatment patterns and costs of patients initiating their first biologic therapy for the treatment of Ankylosing Spondylitis (AS) in Taiwan. Methods: Taiwan’s National Health Insurance claims data between 1/1/2014 and 12/31/2017 was used to identify and follow patients with AS initiating their first biologic therapy in 2015. Patients > 18 years of age, with AS (ICD-9-CM: 720.0), a claim for a biologic therapy in 2015, continuous enrollment for at least one year following index, and no claims for biologics in the previous year were indexed into the study. A matched cohort of non-biologic patients with AS receiving antiinflammatory drugs was derived. Patients were followed from their index date (first biologic claim) through the end of the study period, death, or they were lost to follow-up. Results: There were 430 as patients included in the biologic-initiators cohort (Adalimumab = 191; Etanercept = 122; Golimumab = 177). PRE-index utilization rates were significantly higher for biologic-initiators compared to the matched cohort for corticosteroids, opioids, and csDMARDs (all p<0.0001). utilization rates of NSAIDs and csDMARDs were lower for biologic initiators and higher for the matched cohort during the follow-up period compared to the pre-index period. mean total healthcare costs were higher and average non-medication costs were lower for biologic-initiators compared to the matched cohort during the two years post-index. Conclusions: Patients initiating their first biologic therapy for as had high rates of as-related medication utilization during the pre-index period followed by a decrease in utilization rates after biologic initiation.