Participation in an innovative patient support program reduces prescription abandonment for adalimumab-treated patients in a commercial population
Received 9 May 2019
Accepted for publication 14 August 2019
Published 13 September 2019 Volume 2019:13 Pages 1545—1556
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Amy Norman
Peer reviewer comments 2
Editor who approved publication: Dr Johnny Chen
Diana Brixner,1 Manish Mittal,2 David T Rubin,3 Philip Mease,4 Harry H Liu,5 Matthew Davis,6 Arijit Ganguli,2 A Mark Fendrick7
1Department of Pharmacotherapy, University of Utah College of Pharmacy, Salt Lake City, UT, USA; 2Health Economics and Outcomes Research, AbbVie Inc, North Chicago, IL, USA; 3Section of Gastroenterology, Hepatology and Nutrition, University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, USA; 4Swedish Medical Center and University of Washington School of Medicine, Seattle, WA, USA; 5Health Care, RAND Corporation, Boston, MA, USA; 6Medicus Economics, LLC, Milton, MA, USA; 7Department of Internal Medicine and Department of Health Management and Policy, University of Michigan, Ann Arbor, MI, USA
Correspondence: Diana Brixner
University of Utah College of Pharmacy, Department of Pharmacotherapy, 30 South 2000 East, Salt Lake City, UT 84112, USA
Tel +1 801 581 3182
Fax +1 801 581 3182
Purpose: Nonadherence to indicated therapy reduces treatment effectiveness and may increase cost of care. HUMIRA Complete, a Patient Support Program (PSP), aims to reduce nonadherence in patients prescribed adalimumab (ADA). The objective of this study was to assess the relationship between participation in the PSP and prescription abandonment rates among ADA-treated patients.
Patients and methods: This longitudinal study using patient-level data from AbbVie’s PSP linked with medical and pharmacy claims data included patients ≥18 years with an ADA-approved indication, ≥1 pharmacy claim for ADA, and available data ≥3 months before and ≥6 months after the index date (defined as the initial ADA claim [01/2015 to 02/2017]). Abandonment was defined as reversal of initial ADA prescription with no paid claim during 3-month follow-up. Abandonment rates were compared between PSP and non-PSP cohorts using multivariable logistic regression controlling for potentially confounding baseline characteristics.
Results: In 17,371 patients (9,851 PSP; 7,520 non-PSP), the overall abandonment rate was 10.8–16.8% across indications. The odds of ADA abandonment were 70% less for PSP vs non-PSP patients (5.6% vs 20.4%, odds ratio [OR]=0.30, [95% confidence interval (CI)=0.27–0.33] P<0.001), 38% less for patients using specialty vs retail pharmacy (OR=0.62, 95% CI=0.56–0.69, P<0.001), 20% less for those with income of $50–99K vs $0–49K (OR=0.80, 95% CI=0.69–0.92, P<0.01), and 78% greater for those
with copayment of $26–100 vs $0–25 (OR=1.78, 95% CI=1.55–2.05, P<0.001).
Conclusion: Participation in the PSP, higher income, and using a specialty pharmacy were associated with lower odds of abandoning ADA therapy, whereas increased copayments were associated with greater abandonment. PSPs should be considered to improve initiation of ADA
Keywords: adherence, drug utilization, managed care, outcomes research/analysis, patient education, personnel management
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