title: Treatment patterns, complications, and direct medical costs associated with ankylosing spondylitis in Chinese urban patients: a retrospective claims dataset analysis.
abstract: OBJECTIVE
  To describe treatment pattern, complications, and direct medical costs associated with ankylosing spondylitis (AS) in Chinese urban patients.
  
  
  METHODS
  The 2013 China Health Insurance Research Association (CHIRA) urban insurance claims database was used to identify patients with AS. The identified patients were stratified by AS treatments for the comparisons of well established AS-related complications and direct medical costs. Conventional regression analyses adjusted the collected patient baseline characteristics to confirm the impact of treatments on complications and direct medical costs.
  
  
  RESULTS
  Of the identified 1299 patients with AS, 18.0% received non-steroidal anti-inflammatory drugs (NSAID), 11.2% received immunosuppressant, 48.2% received NSAID plus immunosuppressant, 4.6% received biologic agents, and 17.9% received medications without indication for AS. Biologic group was associated with the lowest proportion of AS-related complications (8.3%) that was confirmed by multiple logistic regression analysis (odds ratio = 0.200, p = .017). The biologic group was also associated with highest direct medical costs (median: RMB = 14,539) that were confirmed by the multiple generalized linear model (coefficient = 1.644, p < .001).
  
  
  CONCLUSIONS
  Biologics were not commonly used for AS in Chinese patients likely due to their high cost. Future studies are needed to confirm the potential long-term clinical benefits associated biologic treatment for AS.
authors.affiliation: a China Health Insurance Research Association , Beijing , PR China.
authors.forename: Jinghu
authors.initials: J
authors.lastname: Li
authors.affiliation: b Beijing North Medical & Health Economics Research Center , Beijing , PR China.
authors.forename: Qingjing
authors.initials: Q
authors.lastname: Liu
authors.affiliation: c Normin Health Changsha Representative Office , Changsha , PR China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Chen
authors.affiliation: b Beijing North Medical & Health Economics Research Center , Beijing , PR China.
authors.forename: Shuangqing
authors.initials: S
authors.lastname: Gao
authors.affiliation: a China Health Insurance Research Association , Beijing , PR China.
authors.forename: Jie
authors.initials: J
authors.lastname: Zhang
authors.affiliation: d Xian Janssen , Beijing , PR China.
authors.forename: Yicheng
authors.initials: Y
authors.lastname: Yang
authors.affiliation: c Normin Health Changsha Representative Office , Changsha , PR China.|e Normin Health , Toronto , Canada.
authors.forename: Wendong
authors.initials: W
authors.lastname: Chen
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D001685:Biological Factors / Q000627:therapeutic use; D002681:China; D003430:Cross-Sectional Studies; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007345:Insurance Claim Review; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D013167:Spondylitis, Ankylosing / Q000150:complications* / Q000188:drug therapy / Q000191:economics*; D014505:Urban Population
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000911:Antibodies, Monoclonal; D001685:Biological Factors; D007166:Immunosuppressive Agents
keywords: Ankylosing spondylitis; China; Complications; Direct medical costs; Treatment pattern