Costs of medication use among patients with juvenile idiopathic arthritis in the Dutch healthcare system

Expert Rev Pharmacoecon Outcomes Res. 2021 Oct;21(5):975-984. doi: 10.1080/14737167.2021.1857241. Epub 2020 Dec 29.

Abstract

Background: This study aims to quantify medication costs in juvenile idiopathic arthritis (JIA), based on subtype.Research design and methods: This study is a single-center, retrospective analysis of prospective data from electronic medical records of JIA patients, aged 0-18 years between 1 April 2011 and 31 March 2019. Patient characteristics (age, gender, subtype) and medication use were extracted. Medication use and costs were reported as: 1) mean total annual costs; 2) between-patient heterogeneity in these costs; 3) duration of medication use; and, 4) costs over the treatment course.Results: The analysis included 691 patients. Mean total medication costs were €2,103/patient/year, including €1,930/patient/year (91.8%) spent on biologicals. Costs varied considerably between subtypes, with polyarticular rheumatoid-factor positive and systemic JIA patients having the highest mean costs (€5,020/patient/year and €4,790/patient/year, respectively). Mean annual medication costs over the patient's treatment course ranged from <€1,000/year (71.1% of patients) to >€11,000/year (2.5% of patients). Etanercept and adalimumab were the most commonly used biologicals. Cost fluctuations over the treatment course were primarily attributable to biological use.Conclusions: Polyarticular rheumatoid-factor positive and systemic JIA patients had the highest mean total annual medication costs, primarily attributable to biologicals. Costs varied considerably between subtypes, individuals, and over the treatment course.

Keywords: Health care costs; health resources; juvenile idiopathic arthritis; treatment costs.

MeSH terms

  • Adolescent
  • Antirheumatic Agents / administration & dosage*
  • Antirheumatic Agents / economics
  • Arthritis, Juvenile / drug therapy*
  • Arthritis, Juvenile / economics
  • Biological Products / administration & dosage*
  • Biological Products / economics
  • Child
  • Child, Preschool
  • Delivery of Health Care / economics
  • Drug Costs
  • Female
  • Humans
  • Infant
  • Male
  • Netherlands
  • Retrospective Studies
  • Time Factors

Substances

  • Antirheumatic Agents
  • Biological Products