Effects of non-medical switching on outcomes among patients prescribed tumor necrosis factor inhibitors

Objective: To evaluate health care use and outcomes among patients who experienced a non-medical switch of their prescribed anti-tumor-necrosis-factor biological agent (anti-TNF) for cost containment reasons. Methods: Retrospective evaluation of Humedica electronic health records of patients ≥18 yea...

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Bibliographic Details
Published in:Current medical research and opinion 2017-11, Vol.33 (11), p.1945-1953
Main Authors: Gibofsky, Allan, Skup, Martha, Mittal, Manish, Johnson, Scott J., Davis, Matthew, Chao, Jingdong, Rubin, David T.
Format: Article
Language:English
Subjects:
Biologics
clinical practice patterns
health resources
immunology
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Summary:Objective: To evaluate health care use and outcomes among patients who experienced a non-medical switch of their prescribed anti-tumor-necrosis-factor biological agent (anti-TNF) for cost containment reasons. Methods: Retrospective evaluation of Humedica electronic health records of patients ≥18 years old with anti-TNF treatment for immune conditions. Using natural language processing, stable patients who experienced a non-medical switch (for cost reasons) of their anti-TNF between 2007 and 2013 were identified (NMS cohort, n = 158) and matched to patients who did not (control cohort, n = 4804). Rates of office visits, emergency department visits, and hospitalizations at 30, 90, and 365 days following were evaluated. Medication-related adverse events, defined as subsequent medication change due to a side effect and/or efficacy-related reason were also compared. Results: Adjusted rates of office visits were higher among the NMS cohort than the control cohort at 30 (46.4% vs. 31.7%, p 
ISSN:0300-7995
1473-4877
DOI:10.1080/03007995.2017.1375903