RESUMO
OBJECTIVE: The goal of the present study was to estimate the treatment costs in immune-mediated rheumatic disease patients initiating treatment with an s.c. biologic agent based on treatment persistence. METHODS: This is a retrospective cohort study based on the German statutory health insurance funds database. Patients ⩾18 years of age with a diagnosis of AS, PsA or RA treated with s.c. TNF-α inhibitors (TNFis) were included. Persistence was estimated as the duration of time from s.c. TNFi therapy initiation to discontinuation, which was defined as at least 60 days without therapy. We performed 1:1 matching based on a propensity score that was constructed as the conditional probability of being persistent as a function of age, gender, index year, physician specialty and Charlson comorbidity index. Finally, the cost differences between the matched pairs were estimated using the Wilcoxon test. RESULTS: After 1:1 matching, 678 persistent and 678 non-persistent patients were available for cost analyses. Using a 2-year time period, the costs for office-based visits per patient were 2319 in the persistent cohort compared with 3094 in the non-persistent cohort (P < 0.001). Co-medication costs were 2828 in the persistent cohort compared with 5498 in the non-persistent cohort, hospitalization costs were 3551 in the persistent cohort compared with 5890 in the non-persistent cohort and sick leave costs were 717 in the persistent cohort compared with 1241 in the non-persistent cohort (all P < 0.001). CONCLUSION: The results of this study indicate that persistence with s.c. TNFi treatment can be associated with several cost offsets for immune-mediated rheumatic disease patients.