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Too Few Get Needed Rheumatoid Arthritis Drugs: Study
Date:2/1/2011

y. Geographically, residents of the Middle and South Atlantic states were least likely to get the drugs, while people in the Pacific region were most likely to get them.

People enrolled in for-profit health plans were less likely than those in not-for-profit plans to get the medications.

The medications, including Plaquenil (hydroxychloroquine), Cuprimine (penicillamine), Remicade (infliximab) and Azulfidine (sulfasalazine), can be used singularly or in combination, the researchers say.

A year's worth of the drugs can range in price from a few hundred dollars for older versions to thousands of dollars for some of the newer prescription medications, the researchers note.

"Since early and aggressive use of disease modifying agents are the main mechanism by which we can reduce morbidity in rheumatoid arthritis, as well as reduce costs, variations based on accidental factors such as these are unacceptable," Schmajuk said.

Commenting on the study, Dr. Ozlem Pala, an assistant professor of clinical medicine in the Division of Rheumatology & Immunology at the University of Miami Miller School of Medicine, said this study provides more evidence that some people don't have access to these important medications.

From Pala's viewpoint, cost is a barrier even though the patients in this study were receiving Medicare benefits. "The costs of these medications can be enormous," she said. "Some of the medications are not expensive, but some of the newer medications are very expensive," she added.

For Medicare patients the out-of-pocket co-payments can run to $4,000 a year, Pala said.

Another reason some patients may not be getting these drugs is that their doctor's don't prescribe them, Pala said. This is particularly true for primary care doctors.

"Patients should be referred to rheumatologists, because none of these medications are comfortably prescribed by primary care doctors, especially the newer agents.
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