title: Dose adjustment over time of etanercept and infliximab in patients with rheumatoid arthritis.
abstract: Dose escalation of biologics in patients with rheumatoid arthritis may affect the cost of care. Longitudinal claims data from a large U.S. health plan were analyzed retrospectively. A total of 4,426 health plan members had a medication claim for either etanercept (N = 690; mean age, 48.4 yr; 72% female) or infliximab (N = 424; mean age, 54.3 yr; 73% female) during the selection period. The study revealed that the mean dosage in patients receiving infliximab for rheumatoid arthritis symptoms increased by 29% from first to last dose. The mean weekly dosage for etanercept remained stable. Etanercept was associated with a significantly lower hazard of dose increase relative to infliximab. The estimated annual costs of infliximab and its administration varied by 31%, whereas the estimated costs of etanercept remained stable over time. This increased dose of infliximab may translate into increased costs for a payer over time.
authors.affiliation: Ingenix, Inc, Eden Prairie, Minnesota, USA.
authors.forename: Lida
authors.initials: L
authors.lastname: Etemad
authors.forename: Elaine B
authors.initials: EB
authors.lastname: Yu
authors.forename: Lee A
authors.initials: LA
authors.lastname: Wanke
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage*; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D018124:Receptors, Tumor Necrosis Factor / Q000008:administration & dosage*; D012189:Retrospective Studies; D014481:United States
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000911:Antibodies, Monoclonal; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D000069285:Infliximab; D000068800:Etanercept