Value in health regional issues · 2025
Economic Impact of Self-Injected Biologics for Rheumatoid Arthritis in Japan: A Propensity Score-Matched Analysis From a Public Healthcare Payer Perspective.
СтатьяНазвание и аннотация: Перевод в очереди
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Takahata Kazuhiko, Akutsu Shingo, Tanaka Eiichi, Sakai Ryoko, Akazawa Manabu
Аннотация
OBJECTIVES: Rheumatoid arthritis (RA) is a chronic inflammatory disease commonly treated with high-cost biologic disease-modifying antirheumatic drugs (bDMARDs). As of May 2025, 12 bDMARDs (9 originators and 3 biosimilars) are approved in Japan, with 10 available for self-injection (SI). Although SI may reduce hospital visits, its overall impact on prescribing patterns and healthcare costs remains unclear.
METHODS: We conducted a retrospective cohort study using Japanese health insurance claims data (DeSC Healthcare, April 2014-August 2023). Patients with RA were identified based on diagnostic codes and bDMARDs prescriptions. Patients initiating SI within 3 months of their first bDMARD prescription were classified as the SI group; others were assigned to the non-SI group. Propensity score matching (1:1) was performed using 25 covariates. From the public payer's perspective, we compared monthly direct healthcare costs, bDMARDs prescription volume, and annual hospital visit frequency.
RESULTS: A total of 6784 patients were matched (mean age: 73.5 years; 73.2% female). The SI group incurred higher monthly healthcare costs ($774.0; 95% confidence interval [CI]: 763.3-784.6) compared with the non-SI group ($608.3; 95% CI 598.3-618.4; P < .05). bDMARDs prescription volume was greater in the SI group (2.9 vs 1.9 units/patient/month; P < .05). However, the SI group had significantly fewer annual hospital visits (9.5 vs 25.0 visits/year; P < .05).
CONCLUSIONS: SI increased direct costs because of higher bDMARDs utilization but reduced hospital visits, suggesting a potential for indirect cost savings. These findings may support future reimbursement and care models for RA.
METHODS: We conducted a retrospective cohort study using Japanese health insurance claims data (DeSC Healthcare, April 2014-August 2023). Patients with RA were identified based on diagnostic codes and bDMARDs prescriptions. Patients initiating SI within 3 months of their first bDMARD prescription were classified as the SI group; others were assigned to the non-SI group. Propensity score matching (1:1) was performed using 25 covariates. From the public payer's perspective, we compared monthly direct healthcare costs, bDMARDs prescription volume, and annual hospital visit frequency.
RESULTS: A total of 6784 patients were matched (mean age: 73.5 years; 73.2% female). The SI group incurred higher monthly healthcare costs ($774.0; 95% confidence interval [CI]: 763.3-784.6) compared with the non-SI group ($608.3; 95% CI 598.3-618.4; P < .05). bDMARDs prescription volume was greater in the SI group (2.9 vs 1.9 units/patient/month; P < .05). However, the SI group had significantly fewer annual hospital visits (9.5 vs 25.0 visits/year; P < .05).
CONCLUSIONS: SI increased direct costs because of higher bDMARDs utilization but reduced hospital visits, suggesting a potential for indirect cost savings. These findings may support future reimbursement and care models for RA.