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Treatment patterns and costs of patients with ankylosing spondylitis initiating biologic therapy in taiwan - a population-based analysis

Ko-Jen Li, Chao-Hsiun Tang, Wesley Furnback, Masayo Sato, Ching-Yun Wei, Bruce CM Wang & Chia-Fang Lee*

Objective: To evaluate the real-world treatment patterns and costs of patients initiating their first biologic therapy for the treatment of ankylosing spondylitis (AS) in Taiwan.

Methods: Taiwan’s National Health Insurance claims data between 1/1/2014 and 12/31/2017 was used to identify and follow patients with AS initiating their first biologic therapy in 2015. Patients >= 18 years of age, with AS (ICD-9-CM: 720.0), a claim for a biologic therapy in 2015, continuous enrollment for at least one year following index, and no claims for biologics in the previous year were indexed into the study. A matched cohort of non-biologic patients with AS receiving anti-inflammatory drugs was derived. Patients were followed from their index date (first biologic claim) through the end of the study period, death, or they were lost to follow-up.

Results: There were 430 as patients included in the biologic-initiators cohort (adalimumab = 191; etanercept = 122; golimumab = 177, etc.). Pre-Index utilization rates were significantly higher for biologic-initiators compared to the matched cohort for corticosteroids, opioids, and csDMARDs (all p<0.0001). Utilization rates of NSAIDs and csDMARDs were lower for biologic initiators and higher for the matched cohort during the follow-up period compared to the pre-index period. Mean total healthcare costs were higher and average non-medication costs were lower for biologic-initiators compared to the matched cohort during the two years post-index.

Conclusions: Patients initiating their first biologic therapy for AS had high rates of as-related medication utilization during the pre-index period followed by a decrease in utilization rates after biologic initiation.