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Treatment patterns, health care resource utilization and costs of rheumatoid arthritis patients in Italy: findings from a retrospective administrative database analysis

Authors Fakhouri W, Lopez-Romero P, Antonelli S, Losi S, Rogai V, Buda S, Sangiorgi D, Perrone V, Degli Esposti L

Received 6 February 2018

Accepted for publication 29 May 2018

Published 10 August 2018 Volume 2018:10 Pages 103—111


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Chuan-Ju Liu

Walid Fakhouri,1 Pedro Lopez-Romero,2 Silvia Antonelli,3 Serena Losi,4 Veronica Rogai,4 Stefano Buda,5 Diego Sangiorgi,5 Valentina Perrone,5 Luca Degli Esposti5

1Eli Lilly & Company, Erl Wood, UK; 2Eli Lilly & Company, Madrid, Spain; 3Eli Lilly Italy S.p.A., Roma, Italy; 4Eli Lilly Italy S.p.A., Sesto Fiorentino, Italy; 5CliCon S.r.l. Health, Economics & Outcomes Research, Ravenna, Italy

Objectives: This study aimed to: 1) describe treatment patterns and drug utilization profile (in terms of therapeutic strategy used, switch, persistence and drug consumption variation) among adult patients affected by rheumatoid arthritis (RA), and 2) estimate the health care resource utilization and its associated direct cost for the management of RA patients.
Methods: A retrospective cohort analysis, using administrative databases of six Local Health Units in Italy, was performed. All adult patients with a confirmed diagnosis of RA between January 1, 2010 and December 31, 2014 were enrolled. The date of the first RA diagnosis according to the study criteria during the study period represented the index date (ID) for each patient. Patients enrolled were observed from the ID for at least 12 months (follow-up period), and their clinical characteristics were investigated for 12 months prior to the ID.
Results: A total of 10,401 patients with a confirmed RA diagnosis were included. Mean age was 63.0 years and 25% were male; 67% of patients were untreated at ID. During the follow-up period, 67.8% of patients treated with biologic agents were persistent with initial therapy, compared to 45.7% for patients on conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), while 11% of patients treated with biologic agents switched during the follow-up period, compared to 17.6% of csDMARDs-treated ones. At the end of the follow-up period, 14.7% of all patients in the analysis had an increase and 12.6% of them had a decrease in their initial drug consumption. The mean cost per RA patient was €3,743.
Conclusion: Our study showed that there is still much that needs to be learned about the prescription of csDMARDs and biologics to RA patients in Italy and to identify areas for future research. The knowledge of RA management in a real-life clinical setting could offer an opportunity to improve the management of RA in Italy.

Keywords: rheumatoid arthritis, treatment patterns, drug utilization, real-world data

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