February 2, 2011

Arthritis Patients Not Getting Recommended Drugs

(Ivanhoe Newswire) -- Patients with rheumatoid arthritis, a crippling disease that eats away at the joints and causes severe pain and swelling, aren't receiving their much-needed, low-cost drugs that prevent deformity.

Despite medical guidelines recommending that patients receive early and aggressive treatment for rheumatoid arthritis with these medications, only 63 percent of Medicare-managed care patients diagnosed with the disease received any amount of the prescription drugs, according to this study.

"Among patients with a true diagnosis of rheumatoid arthritis, closer to 90 percent should be receiving treatment," Gabriela Schmajuk, MD, a postdoctoral scholar in the Division of Immunology and Rheumatology and lead author of the study, was quoted as saying.

The medications, called disease-modifying antirheumatic drugs or DMARDs, have long been available, but in the past 12 or 13 years many more new versions of the drugs have gone on the market. Costs range from many thousands of dollars per year for some of the newer medications to a few hundred dollars for a year of treatment with some of the older drugs.

The study examined variations in medication treatment of 93,143 patients with rheumatoid arthritis who were at least 65 years old between 2005 and 2008. The researchers got the information from the Centers for Medicare and Medicaid HEDIS database. HEDIS is a widely used set of performance measurements in the managed-care industry developed and maintained by the National Committee for Quality Assurance.Commercial health plans participate voluntarily in reporting to the database, but Medicare-managed care plans are required to report results.

Researchers also found that treatment varied dramatically between health-care plans.

"Some plans were doing really well with over 80 percent of patients being treated appropriately," Schmajuk said. "Others plans had fewer than 20 percent of patients getting appropriate care, which is really worrisome. We know this wasn't because of the individual characteristics of patients since the health plan results were adjusted for age, race, income and geographic region."

"Some health plans might have different policies about when patients can see certain specialists," Schmajuk said. "Or one health-care plan might have one rheumatologist for 5,000 patients versus another that provides one for every 500 patients."

SOURCE: Journal of the American Medical Association, published online February 1, 2011