title: Economics of non-adherence to biologic therapies in rheumatoid arthritis.
abstract: Adherence to biologic therapies among patients with rheumatoid arthritis is sub-optimal, with the proportion of adherent patients reported to be as low as 11 %. We found few studies evaluating economic outcomes, including health care costs, associated with non-adherence with biologic therapies. Findings suggest that while higher pharmacy costs drive total health care costs among adherent patients, non-adherent patients incur greater health care utilization including inpatient, outpatient, and laboratory services. Finally, economic factors are important determinants of adherence to biologics in patients with rheumatoid arthritis. Evidence to date has shown that higher out-of-pocket payments have a negative association with adherence to biologics. Furthermore, cost-related non-adherence is a highly prevalent problem in rheumatoid arthritis. Given the high costs of biologics and continued expansion of use in rheumatoid arthritis, there is need for more research to understand the economic implications of adherence to these therapies.
authors.affiliation: University of British Columbia Faculty of Pharmaceutical Sciences, 2405 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada, mdevera@mail.ubc.ca.
authors.forename: Mary A
authors.initials: MA
authors.lastname: De Vera
authors.forename: Jonathan
authors.initials: J
authors.lastname: Mailman
authors.forename: Jessica S
authors.initials: JS
authors.lastname: Galo
mesh_terms: D018501:Antirheumatic Agents / Q000191:economics / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000191:economics*; D001685:Biological Factors / Q000191:economics / Q000627:therapeutic use*; D017048:Health Care Costs; D006801:Humans; D055118:Medication Adherence
chemical_list: D018501:Antirheumatic Agents; D001685:Biological Factors