Patient Preference and Adherence (Sep 2019)
Participation in an innovative patient support program reduces prescription abandonment for adalimumab-treated patients in a commercial population
Abstract
Diana Brixner,1 Manish Mittal,2 David T Rubin,3 Philip Mease,4 Harry H Liu,5 Matthew Davis,6 Arijit Ganguli,2 A Mark Fendrick7 1Department of Pharmacotherapy, University of Utah College of Pharmacy, Salt Lake City, UT, USA; 2Health Economics and Outcomes Research, AbbVie Inc, North Chicago, IL, USA; 3Section of Gastroenterology, Hepatology and Nutrition, University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, USA; 4Swedish Medical Center and University of Washington School of Medicine, Seattle, WA, USA; 5Health Care, RAND Corporation, Boston, MA, USA; 6Medicus Economics, LLC, Milton, MA, USA; 7Department of Internal Medicine and Department of Health Management and Policy, University of Michigan, Ann Arbor, MI, USACorrespondence: Diana BrixnerUniversity of Utah College of Pharmacy, Department of Pharmacotherapy, 30 South 2000 East, Salt Lake City, UT 84112, USATel +1 801 581 3182Fax +1 801 581 3182Email [email protected]: Nonadherence to indicated therapy reduces treatment effectiveness and may increase cost of care. HUMIRA Complete, a Patient Support Program (PSP), aims to reduce nonadherence in patients prescribed adalimumab (ADA). The objective of this study was to assess the relationship between participation in the PSP and prescription abandonment rates among ADA-treated patients.Patients and methods: This longitudinal study using patient-level data from AbbVie’s PSP linked with medical and pharmacy claims data included patients ≥18 years with an ADA-approved indication, ≥1 pharmacy claim for ADA, and available data ≥3 months before and ≥6 months after the index date (defined as the initial ADA claim [01/2015 to 02/2017]). Abandonment was defined as reversal of initial ADA prescription with no paid claim during 3-month follow-up. Abandonment rates were compared between PSP and non-PSP cohorts using multivariable logistic regression controlling for potentially confounding baseline characteristics.Results: In 17,371 patients (9,851 PSP; 7,520 non-PSP), the overall abandonment rate was 10.8–16.8% across indications. The odds of ADA abandonment were 70% less for PSP vs non-PSP patients (5.6% vs 20.4%, odds ratio [OR]=0.30, [95% confidence interval (CI)=0.27–0.33] P<0.001), 38% less for patients using specialty vs retail pharmacy (OR=0.62, 95% CI=0.56–0.69, P<0.001), 20% less for those with income of $50–99K vs $0–49K (OR=0.80, 95% CI=0.69–0.92, P<0.01), and 78% greater for thosewith copayment of $26–100 vs $0–25 (OR=1.78, 95% CI=1.55–2.05, P<0.001).Conclusion: Participation in the PSP, higher income, and using a specialty pharmacy were associated with lower odds of abandoning ADA therapy, whereas increased copayments were associated with greater abandonment. PSPs should be considered to improve initiation of ADAtherapy. Keywords: adherence, drug utilization, managed care, outcomes research/analysis, patient education, personnel management
