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Table 4 B/tsDMARDs treatment and cost in Norwegian RA outpatient clinic patients shown during 2010–2019

From: Exploring drug cost and disease outcome in rheumatoid arthritis patients treated with biologic and targeted synthetic DMARDs in Norway in 2010–2019 – a country with a national tender system for prescription of costly drugs

 

2010

2011

2012

2013

2014

2015

2016

2017

2018

2019

Mean (Range) (2010–2019)

(n = 4909)

(n = 7256)

(n = 7993)

(n = 7278)

(n = 8023)

(n = 9057)

(n = 9176)

(n = 9225)

(n = 9102)

(n = 9335)

Number of treated patients with b/tsDMARDs and number of patients with double or multiple b/tsDMARDs registration errors (RE)

 b/tsDMARD users, N

1936

2855

3136

3060

3419

3688

3770

3869

3869

4158

 

 b/tsDMARD RE, N [%]

23 [1.2]

27 [0.9]

23 [0.7]

28 [0.9]

29 [0.8]

45 [1.2]

139 [3.7]

96 [2.5]

54 [1.4]

51 [1.2]

1.5% (0.7–3.7%)

Number of registered b/tsDMARDs (Percentage of n) [Percentage of the corresponding medication group]

 b/tsDMARDs (%)

1959 (40)

2882 (40)

3159 (40)

3088 (42)

3448 (43)

3733 (41)

3909 (43)

3965 (43)

3923 (43)

4209 (45)

42% (40–45%)

 TNFi [%]

1485 [76]

2134 [74]

2319 [73]

2262 [73]

2469 [72]

2544 [68]

2696 [69]

2668 [67]

2462 [63]

2689 [64]

70% (64–76%)

 Non-TNFi [%]

474 [24]

748 [26]

840 [27]

826 [27]

979 [28]

1189 [32]

1213 [31]

1262 [32]

1183 [30]

1084 [26]

28% (24–32%)

 tsDMARD [%]

NA

NA

NA

NA

NA

NA

NA

35 [0.9]

278 [7.1]

436 [10.4]

6.1% (0.9–10%)

Number of b/tsDMARD users treated with csDMARDs, Methotrexate, and Glucocorticoids (percentage of b/tsDMARD users)

 csDMARD, N (%)

1430 (74)

2086 (73)

2256 (72)

2208 (72)

2415 (71)

2596 (70)

2630 (70)

2676 (69)

2568 (66)

2706 (65)

70% (65–74%)

 Methotrexate, N (%)

1309 (68)

1885 (66)

2035 (65)

1983 (65)

2163 (63)

2282 (62)

2288 (61)

2327 (60)

2243 (58)

2357 (57)

62% (57–68%)

 Glucocorticoids, N (%)

816 (42)

1123 (39)

1181 (38)

1136 (37)

1210 (35)

1277 (35)

1208 (32)

1189 (31)

1144 (30)

1199 (29)

35% (29–42%)

Naïve Starting b/tsDMARD users vs. Non-Naïve starting b/tsDMARD users (percentage of starting b/tsDMARD users) [Percentage of the corresponding medication group]

 All starting b/tsDMARDs

832

887

875

857

852

946

1671

1342

1068

1475

 

 Naïve to b/tsDMARDs

378 (45)

424 (48)

421 (48)

386 (45)

356 (42)

367 (39)

400 (24)

418 (31)

408 (38)

409 (28)

39% (24–48%)

 Naïve to TNFi [%]

326 [86]

382 [90]

384 [91]

350 [91]

310 [87]

308 [84]

362 [91]

372 [89]

327 [80]

355 [87]

88% (80–91%)

 Naïve to Non-TNFi [%]

52 [14]

42 [9.9]

37 [8.8]

36 [9.3]

46 [13]

59 [16]

38 [9.5]

46 [11]

51 [13]

23 [5.6]

11% (5.6–16%)

 Naïve to tsDMARDs [%]

NA

NA

NA

NA

NA

NA

NA

NA

30 [7.4]

31 [7.6]

7.5% (7.4–7.6%)

 Non-naïve to b/tsDMARDs

454 (55)

463 (52)

454 (52)

471 (55)

496 (58)

579 (61)

1271 (76)

924 (69)

660 (62)

1066 (72)

61% (52–76%)

 TNFi [%]

213 [50]

252 [54]

282 [62]

281 [60]

278 [56]

364 [63]

1053 [83]

637 [69]

337 [51]

518 [49]

60% (49–83%)

 Non-TNFi [%]

241 [53]

211 [46]

172 [38]

190 [40]

218 [44]

215 [37]

218 [17]

232 [25]

133 [20]

321 [30]

35% (17–53%)

 tsDMARDs [%]

NA

NA

NA

NA

NA

NA

NA

55 [6.0]

190 [29]

227 [21]

19% (6.0–29%)

The annual mean cost of b/tsDMARDs in thousand Euro [Adjusted consume price index price for 2010 NOK value]

 Current b/tsDMARD cost

13.1 [13.1]

10.6 [10.5]

11.5 [11.1]

10.8 [10.3]

11.5 [10.7]

10.5 [9.7]

9.4 [8.3]

9.6 [8.4]

8.2 [7.1]

6.9 [5.8]

 

 Naïve b/tsDMARD cost

13.0 [13.0]

10.3 [10.2]

11.0 [10.6]

10.1 [9.6]

9.1 [8.4]

6.6 [6.1]

6.4 [5.7]

6.9 [6.0]

5.3 [4.6]

3.2 [2.7]

 

 Non-Naïve b/tsDMARD cost

12.9 [12.9]

10.9 [10.7]

11.7 [11.3]

10.8 [10.3]

10.5 [9.8]

8.1 [7.5]

7.6 [6.7]

7.6 [6.7]

5.9 [5.1]

4.6 [3.9]

 

The annual total cost of b/tsDMARDs in Million Euro [Adjusted consume price index price for 2010 NOK value]

 Current b/tsDMARD cost

25.6 [25.6]

30.7 [30.3]

36.4 [35.0]

33.4 [31.7]

39.6 [36.8]

39.2 [36.1]

36.6 [32.5]

38.1 [33.3]

32.3 [28.0]

28.9 [24.4]

 

 Naïve b/tsDMARD cost

4.9 [4.9]

4.4 [4.3]

4.6 [4.5]

3.9 [3.7]

3.2 [3.0]

2.4 [2.2]

2.6 [2.3]

2.9 [2.5]

2.1 [1.9]

1.3 [1.1]

 

 Non-Naïve b/tsDMARD cost

5.9 [5.9]

5.0 [5.0]

5.3 [5.1]

5.1 [4.8]

5.2 [4.8]

4.7 [4.3]

9.6 [8.5]

7.1 [6.2]

3.9 [3.4]

4.9 [4.2]

 
  1. Note: Data are shown for current users b/tsDMARDs and patients starting a b/tsDMARDs both naïve and not naïve to previous use of b/tsDMARDs
  2. Drugs included in TNFi: etanercept, etanercept SB4, infliximab, infliximab CT-P13, adalimumab, golimumab, certolizumab pegol. Drugs included in Non-TNFi: rituximab, rituximab GP2013, abatacept, and tocilizumab. Drugs included in tsDMARDs: baricitinib and tofacitinib
  3. Abbreviations: RA Rheumatoid Arthritis, b/tsDMARDs biologic and target synthetic Disease-Modifying Antirheumatic Drugs, tsDMARDs target Synthetic DMARDs, csDMARDs conventional synthetic DMARDs, TNFi Tumor Necrosis Factor inhibitor (TNFi and Non-TNFi are subcategories of biologic DMARDs), NA Not available, NOK Norwegian Krones