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Out-of-Pocket Costs Limit Access to Arthritis Drugs

Insurance woes keep rheumatoid arthritis patients from biologic meds, study finds

TUESDAY, May 25 (HealthDay News) -- Effective but expensive biologic drugs are less likely to be used by American rheumatoid arthritis patients who have inadequate health insurance or are struggling with medical co-payments, a new study reveals.

Biologics, which alter immune system function, are sometimes used to treat rheumatoid arthritis when more conventional treatments don't work.

"Our study showed that out-of-pocket cost is a concern in the decision to initiate these drugs," lead author Pinar Karaca-Mandic, an assistant professor in the School of Public Health at the University of Minnesota, said in a news release. "If higher cost-sharing forces people away from preferred, effective therapy, they could end up with higher complication and medical costs."

Karaca-Mandic and her research team released their findings online May 24 in advance of publication in an upcoming print issue of the journal Health Services Research.

The cautionary note stems from an analysis of health insurance data gleaned from 35 large, private U.S. employers from 2000 to 2005.

From a pool of more than 8,500 newly diagnosed rheumatoid arthritis patients, the authors found that 2,066 of them had used one of the three most commonly prescribed biotech drugs: etanercept (Enbrel), adalimumab (Humira) or infliximab (Remicade).

However, the team found that the likelihood of taking any of these drugs was lower among patients who had to pay more for them. What's more, unmanageable costs also raised the risk that those who started a biotech regimen would end up abandoning the treatment.

Rheumatoid arthritis patients from families already burdened with high health costs overall were less than 50 percent as likely to begin a biotech regimen in the first place, the authors found, although those who did so anyway were not more likely to stop once they started.

"Families have a separate budget for health care, and may not be flexible around expanding it," noted Karaca-Mandic. "If other members are getting sick, they may want to draw resources away from the rheumatoid arthritis patient."

More information

For more on rheumatoid arthritis, visit the U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases.

-- Alan Mozes

SOURCE: Health Behavior News Service, news release, May 21, 2010

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