Vue.component('pdc-ra-overview', { template: '
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Adherence to Non-Infused Biologic Medications Used to Treat Rheumatoid Arthritis (PDC-RA)

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Description

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The percentage of individuals 18 years and older with rheumatoid arthritis (RA) who met the Proportion of Days Covered (PDC) threshold of 80% during the measurement year for biologic medications used to treat RA.

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A higher rate indicates better performance.

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Additional Information

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Intended Use

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Performance measurement for health plans.

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Data Sources

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Prescription claims data.

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Denominator

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Individuals with both of the following:

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  • A rheumatoid arthritis diagnosis during the measurement year
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  • ≥2 prescription claims for non-infused biologic medications used to treat RA on different dates of service, for which the sum of the days' supply is 56 days or greater during the treatment period.
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Exclusions

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Hospice or use of infused biologic medications used to treat RA.

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Numerator

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Individuals who met the PDC threshold of 80% during the measurement year.

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' }); Vue.component('pdc-ra-ref-1', { template: '' + 'Donahue KE, Gartlehner G, Jonas DE, et al; for the Agency for Healthcare Research and Quality. Comparative Effectiveness Of Drug Therapy For Rheumatoid Arthritis And Psoriatic Arthritis In Adults. Comparative Effectiveness Review No.11. AHRQ publication. 2017 [cited 2011 Nov 1]; 08-EHC004-EF. Available from: http://www.effectivehealthcare.ahrq.gov/ehc/products/14/68/RheumArthritisFinal.pdf.' + '1' + '' }); Vue.component('pdc-ra-ref-2', { template: '' + 'Lawrence RC, Felson DT, Helmick CG, et al. National Arthritis Data Workgroup. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II. Arthritis Rheum. 2008; 58(1):26-35. PMID: 18163497.' + '2' + '' }); Vue.component('pdc-ra-ref-3', { template: '' + 'Myasoedova E, Crowson CS, Kremers HM, et al. Is the incidence of rheumatoid arthritis rising?: results from Olmsted County, Minnesota, 1955-2007. Arthritis Rheum. 2010; 62(6):1576-82. PMID: 20191579.' + '3' + '' }); Vue.component('pdc-ra-ref-4', { template: '' + 'Centers for Disease Control and Prevention. Rheumatoid Arthritis [Internet]. [cited 2017 Nov 15]. Available from: https://www.cdc.gov/arthritis/basics/rheumatoid-arthritis.html.' + '4' + '' }); Vue.component('pdc-ra-ref-5', { template: '' + 'Kvien TK. Epidemiology and burden of illness of rheumatoid arthritis. Pharmacoeconomics. 2004; 22(2 Suppl 1):1-12. PMID: 15157000.' + '5' + '' }); Vue.component('pdc-ra-ref-6', { template: '' + 'Burton W, Morrison A, Maclean R, et al. Systematic review of studies of productivity loss due to rheumatoid arthritis. Occup Med (Lond). 2006; 56(1):18-27. PMID: 16286432.' + '6' + '' }); Vue.component('pdc-ra-ref-7', { template: '' + 'Xie F. The need for standardization: a literature review of indirect costs of rheumatoid arthritis and osteoarthritis. Arthritis Rheum. 2008; 59(7):1027-33. PMID: 18576305.' + '7' + '' }); Vue.component('pdc-ra-ref-8', { template: '' + 'Gunnarsson C, Chen J, Rizzo JA, et al. The Employee Absenteeism Costs of Rheumatoid Arthritis: Evidence From US National Survey Data. J Occup Environ Med. 2015; 57(6):635-42. PMID: 26053366.' + '8' + '' }); Vue.component('pdc-ra-ref-9', { template: '' + 'Singh JA, Saag KG, Bridges SL Jr, et al. 2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. Arthritis Rheumatol. 2016; 68(1):1-26. PMID: 26545940.' + '9' + '' }); Vue.component('pdc-ra-ref-10', { template: '' + 'Curtis JR, Singh JA. Use of biologics in rheumatoid arthritis: current and emerging paradigms of care. Clin Ther. 2011; 33(6):679-707. PMID: 21704234.' + '111' + '' }); Vue.component('pdc-ra-ref-11', { template: '' + 'Contreras-Yáñez I, Ponce De León S, Cabiedes J, et al. Inadequate therapy behavior is associated to disease flares in patients with rheumatoid arthritis who have achieved remission with disease-modifying antirheumatic drugs. Am J Med Sci. 2010; 340(4):282-90. PMID: 20881757.' + '11' + '' }); Vue.component('pdc-ra-ref-12', { template: '' + 'Pascual-Ramos V, Contreras-Yáñez I, Villa AR, et al. Medication persistence over 2 years of follow-up in a cohort of early rheumatoid arthritis patients: associated factors and relationship with disease activity and with disability. Arthritis Res Ther. 2009; 11(1):R26. PMID: 19228421.' + '12' + '' }); Vue.component('pdc-ra-ref-13', { template: '' + 'Harnett J, Wiederkehr D, Gerber R, et al. Primary Nonadherence, Associated Clinical Outcomes, and Health Care Resource Use Among Patients with Rheumatoid Arthritis Prescribed Treatment with Injectable Biologic Disease-Modifying Antirheumatic Drugs. J Manag Care Spec Pharm. 2016; 22(3):209-18. PMID: 27003550.' + '13' + '' }); Vue.component('pdc-ra-rationale', { template: '
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Rationale

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Rheumatoid arthritis (RA) is a chronic and progressive inflammatory disease that can lead to premature mortality and reduce a person's health and quality of life. RA affects an estimated 1.3-1.5 million Americans,, and while one study found that prevalence decreased from 1995 to 2005, another found an increase in overall prevalence from 2005 to 2007. Certain genetic traits, environmental causes, and lifestyle behaviors are thought to contribute to RA's etiology RA is 2 to 3 times more likely in women than men,, and, it is estimated that morbidity, mortality, and disability due to RA are likely to increase in older adults.

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RA is also a significant driver of costs for both treatment of the disease and its complications, causing a substantial impact on both direct healthcare costs and indirect costs associated with productivity loss, absenteeism, and disability.,, In 2015, it was estimated that the national indirect costs of RA-related absenteeism were $252 million annually. However, appropriate treatment can prevent loss of function and improve patients' quality of life.

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Most RA patients require continuous treatment to control flares and disease progression., Current evidence-based guidelines from the American College of Rheumatology recommend the use of self-injectable, biologic disease-modifying antirheumatic drugs (DMARDs) for both early symptomatic and well-established disease. Biologic DMARDs are frequently used in combination with synthetic DMARDs or corticosteroids to manage symptoms and control disease progression., Although biologic treatments are considerably more expensive than traditional oral treatments, for many patients they offer improved efficacy, reduced disability, and improved quality of life.

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The full benefits of self-injectable biologic treatments can only be achieved when patients are adherent to their medication regimen; however, many patients have difficulty taking their medications as often as directed. Nonadherent populations have been shown to be at a higher risk of flare-up, and overall, they experience more frequent flares compared to those who were more adherent to therapy. Currently, non-adherence rates range from 20-70%., Higher adherence levels for patients result in a reduction in health care expenditures and improvements in quality of life., Thus, improvements in RA medication adherence would be expected to moderate disease progression, reducing the utilization of medical services and the associated costs.,,

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