Report Summarizes Rheumatoid Arthritis Study Findings from J. Shafrin and Co-Researchers (Geographic Variation in the Quality and Cost of Care for…

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Report Summarizes Rheumatoid Arthritis Study Findings from J. Shafrin and Co-Researchers (Geographic Variation in the Quality and Cost of Care for Patients with Rheumatoid Arthritis)

By a News Reporter-Staff News Editor at Insurance Weekly News -- Data detailed on Autoimmune Diseases and Conditions - Rheumatoid Arthritis have been presented. According to news reporting originating from Los Angeles, California, by VerticalNews correspondents, research stated, "There is considerable push to improve value in health care by simultaneously increasing quality while lowering or containing costs. However, for diseases that are best treated with comparatively expensive treatments, such as rheumatoid arthritis (RA), there could be tension between these aims."

Our news editors obtained a quote from the research, "In this study, we measured geographic variation in quality, access, and cost for patients with RA, a disease with effective but costly specialty treatments. To assess the geographic differences in the quality, access, and cost of care for patients with RA. Using large claims databases covering the period between 2008 and 2014, we measured quality of care metrics by metropolitan statistical areas (MSAs) for patients with RA. Quality measures included use of disease-modifying antirheumatic drugs (DMARDs) and tuberculosis (TB) screening before initiating biologic DMARD therapy. Access to care measures included measured detection and the share of patients with RA who visited a rheumatologist. Regression models were used to control for differences in patient demographics and health status across MSAs. For the 501,376 patients diagnosed with RA, in the average MSA 64.1% of RA patients received a DMARD, and 29.6% of RA patients initiating a biologic DMARD appropriately received a TB screening. Only 17% (73/430) of MSAs comprised the top 2 Medicare Advantage star ratings for DMARD use. Measured detection was 0.59% (IQR = 0.47/0-0.71%; CV = 0.355) on average, and 57.6% (IQR=48%-69%; CV=0.341) of RA patients visited a rheumatologist. MSAs with the highest DMARD use spent $26,724 (in 2015 U.S. dollars) annually treating patients with RA, $5,428 more (P < 0.001) than low DMARD-use MSAs, largely because of higher pharmacy cost ($5,090 vs. $7,610, P<0.001). However, MSAs with higher DMARD use had lower RA -related inpatient cost ($1,890 vs. $2,342, P=0.024). There were significant geographic variations in the quality of care received by patients with RA, although quality was poor in most areas. Fewer than 1 in 5 MSAs could be considered high quality based on patient DMARD use. Access to specialist care may be an issue, since just over half of patients with RA visited a rheumatologist annually."

According to the news editors, the research concluded: "Efforts to incentivize better quality of care holds promise in terms of unlocking value for patients, but for some diseases, this approach may result in higher costs."

For more information on this research see: Geographic Variation in the Quality and Cost of Care for Patients with Rheumatoid Arthritis. Journal of Managed Care & Specialty Pharmacy, 2016;22(12):1472-1481. Journal of Managed Care & Specialty Pharmacy can be contacted at: Acad Managed Care Pharmacy, 100 N Pitt St, 400, Alexandria, VA 22314-3134, USA.

The news editors report that additional information may be obtained by contacting J. Shafrin, Precis Hlth Econ, Los Angeles, CA 90025, United States. Additional authors for this research include A. Ganguli, Y.S. Gonzalez, J.J. Shim and S.A. Seabury.

Keywords for this news article include: Los Angeles, California, United States, North and Central America, Quality of Care, Diagnostics and Screening, Epidemiology, Musculoskeletal Diseases and Conditions, Autoimmune Diseases and Conditions, Joint Diseases and Conditions, Rheumatoid Arthritis.