AB0360 EVALUATION OF HEALTHCARE RESOURCE UTILISATION AND COSTS OF SJöGREN’S SYNDROME: PATIENTS WITH RHEUMATOID ARTHRITIS TREATED WITH ABATACEPT OR ANTI-TNF DMARDS
Authors: Evo Alemao, Aarti Rao, Joe Zhuo, Chidananda Samal, Robert Wong, Paul Allison
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Sjögren's syndrome (SS) is considered an extra-articular manifestation of RA and is an autoantibody-mediated condition similar to RA. In an open-label, prospective, observational multicentre study, abatacept (ABA) was found to be effective for both RA and SS-related manifestations.<sup>1</sup> However, there are limited data on the healthcare resource utilisation (HCRU) and cost in patients (pts) with RA with SS managed with ABA compared with those managed with anti-TNFs. <h3>Objectives</h3> To evaluate the HCRU and cost for pts with SS associated with RA treated with ABA or anti-TNF DMARDs. <h3>Methods</h3> Pts (≥18 years) from the Truven MarketScan™ administrative claims database with incident RA (≥2 claims for RA using International Classification of Diseases [ICD]-9 or ICD-10 codes and ≥1 claim for a conventional DMARD), incident SS (≥1 claim for SS using ICD-9 or ICD-10 codes) and with a prescription for ABA or an anti-TNF on or after the first diagnosis of SS from Jan 2011 to Sep 2017 were included. Pts were divided into two mutually exclusive cohorts. Pts with prescriptions for both ABA and an anti-TNF were excluded. The index date was the date of ABA or anti-TNF prescription. All-cause HCRU (healthcare visits) and costs were captured during the 2-year enrolled period prior to the index date (baseline) and in the 2-year enrolled follow-up period or until the pt was taken off the index drug, whichever occurred earlier. The baseline and follow-up periods were divided into intervals of 6 months each. Total healthcare visits (inpatient, outpatient, emergency care, urgent care and pharmacy) and total healthcare costs associated with these visits were calculated for each interval. A fixed-effects model was used to compare the HCRU and costs for pts taking ABA vs anti-TNFs after controlling for baseline Charlson Comorbidity Index and other comorbidities of interest. <h3>Results</h3> Overall, 1367 pts met inclusion criteria, of which 148 (10.8%) and 1219 (89.2%) were treated with ABA and anti-TNFs, respectively. ABA (vs anti-TNF) pts were older and had a higher comorbidity index (Table 1). Overall HCRU decreased in both the ABA and anti-TNF groups (relative to pts not being treated with biologic DMARDs). The HCRU was lower in ABA pts vs anti-TNF pts (average visits 20.0 vs 20.8, Figure 1) in the adjusted analysis. The average adjusted total healthcare cost for ABA (vs anti-TNF) pts was lower in the four 6-month cycles evaluated (average cost $17,050 vs $27,469; Figure 1). The overall healthcare costs were primarily driven by all-cause pharmacy cost (data not shown). <h3>Conclusion</h3> Pts with RA with SS managed with abatacept had lower HCRU and costs relative to pts managed with anti-TNFs. Further analysis is warranted to understand the drivers of the differential economic burden among pts with RA with SS. <h3>References: </h3> [1] Tsuboi H, et al. Mod Rheumatol 2016;26:891–9. <h3>Disclosure of Interests</h3> Evo Alemao Shareholder of: Bristol-Myers Squibb, Employee of: Bristol-Myers Squibb, Aarti Rao Consultant for: Bristol-Myers Squibb, Joe Zhuo Shareholder of: Bristol-Myers Squibb, Employee of: Bristol-Myers Squibb, Chidananda Samal Consultant for: Bristol-Myers Squibb, Robert Wong Shareholder of: Bristol-Myers Squibb, Employee of: Bristol-Myers Squibb, Paul Allison: None declared