title: Persistence with biologic agents for the treatment of rheumatoid arthritis in Japan.
abstract: BACKGROUND
  To assess persistence rates of biologic agents for the treatment of rheumatoid arthritis in Japan.
  
  
  METHODS
  Based on Japanese claims data of 16,214 patients between 2012 and 2014, 6-, 12-, and 18-month persistence rates of different biologic agents were calculated. Determinants of persistence were assessed by means of a multivariate Cox proportional hazard model controlling for age, sex, and comorbidities. A sensitivity analysis was performed with different definitions of persistence and parametric survival analysis.
  
  
  RESULTS
  Overall persistence rates in Japan are high and reach 86% after 1 year in the entire sample. The persistence rate for the biologic-naïve subpopulation is above 95%. Persistence is higher for older patients (hazard ratio 0.60 [95% confidence interval 0.40-0.91] for >75 years compared to ≤60 years) and lower for patients with a high comorbidity score (hazard ratio 1.33; 95% confidence interval 1.03-1.70 for Charlson Comorbidity Index score 3-5 compared to ≤2). We found a high variation of persistence between different drugs.
  
  
  CONCLUSIONS
  Japanese rheumatoid arthritis patients have a high persistence rate of biologic treatments. However, multiple factors affect the persistence rate of Japanese patients, including age, comorbidities, and patient type. Naïve patients tend to have a higher persistence rate than continuing biologic patients.
authors.affiliation: Health Economics, Janssen Pharmaceutical KK, Tokyo, Japan; Düsseldorf Institute for Competition Economics (DICE), University of Düsseldorf, Düsseldorf, Germany.
authors.forename: Jörg
authors.initials: J
authors.lastname: Mahlich
authors.affiliation: Health Economics, Janssen Pharmaceutical KK, Tokyo, Japan; Center of Pharmaceutical Outcomes Research, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.
authors.forename: Rosarin
authors.initials: R
authors.lastname: Sruamsiri
keywords: Japan; biologics; database analysis; persistence; rheumatoid arthritis