Pharmacoepidemiology and Treatment Costs of Rheumatoid Arthritis Based on Real-World Data from the Argentine Province of Neuquen: Descriptive Study (2012-2023)
DOI:
https://doi.org/10.31052/1853.1180.v30.n1.42890Keywords:
Arthritis Rheumatoid, Antirheumatic Agents, Health Care Costs, Economics,, Pharmaceutical, Drug UtilizationAbstract
Introduction: Rheumatoid arthritis affects life quality, causes loss of work productivity, and generates high social health costs, to the point of being considered as a catastrophic disease. To treat this condition, biological disease-modifying drugs have been available since 2000. Concerns about their use include variability in prescription, monitoring of adverse effects, and cost. Real World Evidence (RWE) is defined as evidence derived from the analysis of real-world data. The objective of this study was to investigate the pharmacoepidemiological burden and costs of biological drugs for the treatment of rheumatoid arthritis in a public health system. Methods: This descriptive study is based on real-world data from 1034 patients who get medicine for rheumatoid arthritis in the public health sector of the Province of Neuquen over an 11-year period. Results: The prevalence of rheumatoid arthritis was estimated at 0.43%, with 4.25% of patients receiving biological drugs. Over 11 years, the use of these drugs increased by 1000%; the main reason for their prescription is lack of response and/or adverse events with non-biological drugs. The most commonly used drug was Etanercept, with an annual cost 113 times higher than Methotrexate. Conclusions: This study allowed the identification of adverse effects not habitually reported through pharmacovigilance, the description of common prescription patterns, and the monitoring of intervention costs once incorporated into the health system.
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Secco A, Alfie V, Espinola N, Bardach A. Epidemiología, uso de recursos y costos de la artritis reumatoidea en Argentina; Instituto Nacional de Salud; Revista Peruana de Medicina Experimental y Salud Pública;2020; 37 (3):532-540. DOI: 10.17843/rpmesp.2020.373.4766.
Scublinsky D, Venarotti H, Citera G, et al. The prevalence of rheumatoid arthritis in Argentina: a capture-recapture study in a city of Buenos Aires province. J Clin Rheumatol. 2010;16(7):317-321. doi:10.1097/RHU.0b013e3181f3bfdd
Gubner, R., August, S., & Ginsberg, V. (1951). Therapeutic suppression of tissue reactivity. 2. Effect of aminopterin in rheumatoid arthritis and psoriasis. American Journal of Medical Sciences, 221, 176-182.
FDA. Ficha Técnica Del Producto Embrel / Etanercept para pacientes con Artritis Reumatoidea. Noviembre 1998. Disponible en https://www.accessdata.fda.gov/drugsatfda_docs/label/1998/etanimm110298lb.pdf
Mease PJ, Stryker S, Liu M, et al. Treatment patterns in rheumatoid arthritis patients newly initiated on biologic and conventional synthetic disease-modifying antirheumatic drug therapy and enrolled in a North American clinical registry. Arthritis Res Ther; 2021;23(1):236. doi:10.1186/s13075-021-02599-4
Sampaio Buffon P, Da Mata B, Valim V et al. Temporal trend of prescription of biological therapies for rheumatoid arthritis. Rev. Bras. Pesq. Saúde; 2019; 21(3): 77-84. doi: 10.5151/sbr2019-591.
Carlo Vinicio Caballero Uribe. Artritis reumatoide como enfermedad de alto costo. Revista Colombiana De Reumatología; 2004; 11(3): 225-231
Lamfre, L., Hutter, F., Álvarez, et al. (2018). Evaluaciones económicas en un sistema de salud fragmentado: oportunidades y desafíos metodológicos para Argentina. Revista Argentina de Salud Pública; 2018; 9(37):37-42.
Berger, M. et. al (2017). A Framework for Regulatory Use of Real-World Evidence. https://healthpolicy.duke.edu/sites/default/files/2020-08/rwe_white_paper_2017.09.06.pdf
Ministerio de Salud de la Provincia de Neuquén. Formulario Terapéutico de Medicamentos. Disponible en https://www.saludneuquen.gob.ar/formulario-terapeutico-provincial/
28ª Conferencia Sanitaria Panamericana. CSP28/11 - Evaluación e incorporación de tecnologías sanitarias en los sistemas de salud.64ª Sesión del Comité Regional. Washington, D.C., EUA, del 17 de septiembre del 2012. Disponible en https://www.paho.org/es/documentos/csp2811-evaluacion-e-incorporacion-tecnologias-sanitarias-sistemas-salud
Ley Nacional Nº 25.649 Prescripción de medicamentos genéricos. República Argentina. Disponible en https://www.argentina.gob.ar/normativa/nacional/ley-25649-77881
Ley Provincial Nº 2392. Prescripción por medicamentos genéricos. Provincia de Neuquén. Disponible en http://200.70.33.130/index.php/normativas-provinciales/leyes-provinciales/1282
García de Yébenes M, Loza E. Artritis reumatoide: epidemiología e impacto sociosanitario;Reumatol Clin Supl. 2018; 14 (2):3-6.
Acevedo-Vásquez EM. Algunos aspectos de la artritis reumatoide en Perú. Rev Soc Peru Med Interna; 2012;25(1):31-37.
Díaz-Rojas J, Dávila-Ramírez F, Quintana-López G et al. Prevalencia de artritis reumatoide en Colombia: una aproximación basada en la carga de la enfermedad durante el año 2005. Rev Colomb Reumatol; 2016;23(1):11–16
Almutairi K, Nossent J, Preen D, Keen H , Inderjeeth C. The prevalence of rheumatoid arthritis: a systematic review of population-based studies. The Journal of rheumatology; 2021; 48(5), 669-676. doi:10.3899/jrheum.200367
Arturi P, Orazio A`, Citera G, Cocco J. Indicación de terapia biológica en pacientes con enfermedades reumáticas de la consulta ambulatoria. Rev Argent Reumatol; 2008;19(1):34-8.
Kirmayr K, Garibotti G. Patrones de Tratamiento con Agentes Biológicos en Pacientes con Artritis Reumatoidea: Asociación con su sobrevida. Rev Argent Reumatol; 2017;Supl 1:20
Smolen J, Landewé R, Bergstra S, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2022 update. Ann Rheum Dis; 2023;82:3–18. doi:10.1136/ard-2022-223356.
WHO. Essential Medicines List 2022. Disponible en https://list.essentialmeds.org/
Rheumatoid arthritis in adults: management NICE guideline [NG100 ]Published: 11 July 2018 Last updated: 12 October 2020. Disponible en https://www.nice.org.uk/guidance/ng100
De la Vega Roberti M, Gómez M, Benitez M , et al. Características de los tratamientos biológicos en enfermedades reumáticas en Argentina: quinto informe del registro BIOBADASAR. Rev Arg Reumatol; 2016;27(1): 14-24.
Daniel G, Silcox C, Bryan J, et al. Characterizing RWD quality and relevancy for regulatory purposes; 2019 1, 2018. Duke Margolis Center for Health Policy.
Neuquén Informa (1 de febrero de 2023) Neuquén es la segunda provincia en crecimiento poblacional (internet). Disponible en https://www.neuqueninforma.gob.ar/neuquen-es-la-segunda-provincia-en-crecimiento-poblacional/
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