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Persistence with biologic agents for the treatment of rheumatoid arthritis in Japan

Authors Mahlich J, Sruamsiri R

Received 8 April 2016

Accepted for publication 21 June 2016

Published 5 August 2016 Volume 2016:10 Pages 1509—1519

DOI https://doi.org/10.2147/PPA.S110147

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Dr Johnny Chen

Jörg Mahlich,1,2 Rosarin Sruamsiri1,3

1Health Economics, Janssen Pharmaceutical KK, Tokyo, Japan; 2Düsseldorf Institute for Competition Economics (DICE), University of Düsseldorf, Düsseldorf, Germany; 3Center of Pharmaceutical Outcomes Research, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand

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.
Conclusion: 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.

Keywords: Japan, rheumatoid arthritis, database analysis, persistence, biologics

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