Rheumatoid Arthritis Needs Specialty Pharmacy

Jan 21, 2013

Rheumatoid arthritis patients using a specialty pharmacy are more adherent and have lower medical costs than community-based retail pharmacy RA patients.

  • Inflammatory Conditions

New research by Express Scripts, published in the American Journal of Pharmacy Benefits (AJPB), finds that rheumatoid arthritis (RA) patients using a specialty pharmacy have higher rates of medication adherence and significantly lower medical costs than community-based retail pharmacy RA patients. 

RA affects an estimated 1.3 million Americans. Treatment of the disease and its complications are major drivers of healthcare costs. Because of the debilitating nature of the condition, indirect costs due to productivity loss and absenteeism also can be significant.

The Express Scripts study was conducted over a three-year period and compared the differences in adherence, medical utilization, and medication and medical costs for RA patients using a specialty pharmacy and those using a retail pharmacy. The following was found:

  • Specialty pharmacy patients had significantly higher adherence rates throughout the three-year study (in year three: 60.5% of specialty patients were adherent versus 44% of retail patients).
  • Specialty patients were less likely than retail patients to have physician office visits and their risk of emergency room visits was significantly lower than for retail patients.
  • Medical costs were substantially less for specialty patients than for those using retail – lower by a range of $1,099 to $2,137 over the three years.
  • Medication costs were higher for the specialty patients because of their higher rate of adherence.

As reported in our recent Drug Trend Quarterly, specialty pharmaceutical spend grew 22.6% in the first nine months of 2012 compared to the same time period in 2011. RA medications ranked No.1 in the percentage of spending for specialty medications at 28.7%.

Our specialty pharmacy, Accredo, provides services for patients with certain complex and chronic conditions through our unique Therapeutic Resource Centers (TRCs). The TRCs are segmented by therapy and provide programs for a number of therapeutic areas, including RA.

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Lab Staff
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