Demographics, treatment patterns, and healthcare utilization and cost of repository corticotropin injection in patients with systemic lupus erythematosus or rheumatoid arthritis

Figures & data

Figure 1. Study time frame.

Figure 2. Patient attrition.

Figure 3. Medication use before and after the initiation of RCI in the SLE and RA population.

Table 1. Demographic and clinical characteristics of RCI patients in the RA and SLE population.

	RCI patients
	RA (n = 180)	SLE (n = 29)
Age at diagnosis, mean (SD)	60.5 (15.7)	45.1 (12.9)
≥65 years old, %	59.4%	10.3%
Female, %	56.1%	89.7%
Medicare advantage, %	66.1%	6.9%
DCI score^a, mean (SD)	1.1 (1.4)	2.6 (1.6)
Plan type, %
HMO	6.1%	17.2%
PPO	90.0%	65.5%
CDHP	3.9%	17.2%
Residence region, %
Northeast	5.0%	3.4%
Midwest	7.2%	20.7%
South	75.0%	41.4%
West	12.8%	34.5%
Comorbid conditions, rate per 1,000 patient years^a
Multiple sclerosis	56	147
Rheumatoid arthritis	N/A	165
Systemic lupus erythematosus	169	N/A
Systematic dermatomyositis	103	73
Proteinuria	103	92
Anemia	132	201
Anxiety	75	183
Depression	141	201
Hypertension	348	293
Diabetes mellitus	132	92

CDHP, consumer-driven health plan; DCI, Deyo-Charlson Comorbidity Index; HMO, health maintenance organization; PPO, preferred provider organization; RA, rheumatoid arthritis; RCI, Repository corticotropin injection (H.P. Acthar Gel); SD, standard deviation; SLE, systemic lupus erythematosus.

^aRate per 1,000 patient years = (total number of patients with ≥1 diagnosis for disease of interest/total number of patient years of follow-up during the time period of interest) * 1,000.

Table 2. All-cause and disease-related healthcare utilization during pre- and post-initiation period.

	RCI patients: pre- vs post-initiation
	RA (n = 180)			SLE (n = 29)
	Pre	Post	p-value	Pre	Post	p-value
Months of follow-up, mean (SD)	7.1 (14.9)	17.0 (19.8)		22.6 (21.8)	23.9 (20.9)
Hospitalization, number of patients per 1,000 patient-years
All-cause	42	25	<.01	238	190	.40
Disease-related	13	4	<.01	183	138	.42
ED visit, number of patients per 1,000 patient-years
All-cause	48	23	.04	238	208	.59
Disease-related	8	1	.01	128	87	.41
Outpatient encounters, number of visits per patient year
All-cause	56	47	<.01	44	40	<.01
Disease-related	10	5	<.01	8	9	.49
Prescriptions, number of fills per patient year
All-cause	73	39	.26	44	39	<.01
Disease-related	17	5	.06	15	10	<.01
RCI fills  # of RCI fills, mean (SD)	0	4.8 (4.6)	—	0	3.7 (5.4)	—

Abbreviations. ED, emergency department; RA, rheumatoid arthritis; RCI, Repository corticotropin injection (H.P. Acthar Gel); SD, standard deviation; SLE, systemic lupus erythematosus.

Table 3. All-cause and disease-related healthcare cost PPPM during pre- and post-initiation period.

	RCI patients: pre- vs post-initiation
	RA (n = 180)				SLE (n = 29)
	Pre	Post	Diff	p-value	Pre	Post	Diff	p-value
Months of follow-up, mean (SD)	7.1 (14.9)	17.0 (19.8)			22.6 (21.8)	23.9 (20.9)
All-cause healthcare costs, PPPM
Total costs	$2,751	$5,487	$2,736	<.01	$6,774	$11,167	$4,393	.07
Total medical costs	$1,881	$682	($1,199)	<.01	$5,869	$3,724	($2,145)	.14
Hospitalization	$1,579	$503	($1,076)	<.01	$3,192	$799	($2,393)	.04
Emergency department	$118	$41	($78)	<.01	$163	$84	($79)	.26
Outpatient encounter	$184	$95	($89)	<.01	$2,513	$2,840	$327	.66
Skilled nursing facility	$0	$43	$43	<.01	$0	$0	$0	.79
Prescription	$869	$4,805	$3,936	<.01	$905	$7,443	$6,538	<.01
Disease-related healthcare costs, PPPM
Total costs	$931	$4,472	$3,541	<.01	$3,077	$7,522	$4,444	.04
Total medical costs	$658	$93	($565)	<.01	$3,011	$893	($2,119)	.02
Hospitalization	$614	$86	($528)	<.01	$2,444	$434	($2,011)	.02
Emergency department	$12	$0	($12)	<.01	$49	$41	($8)	.80
Outpatient encounter	$32	$7	($25)	<.01	$518	$418	($100)	.66
Skilled nursing facility	$0	$0	$0	<.01	$0	$0	$0	.79
Prescription	$273	$4,379	$4,106	<.01	$66	$6,629	$6,563	<.01

Abbreviations. Diff, difference (pre-initiation period as reference group); PPPM, per patient per month; RA, rheumatoid arthritis; RCI, Repository corticotropin injection (H.P. Acthar Gel); SD, standard deviation; SLE, systemic lupus erythematosus.