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HMOs Denying Arthritis Patients New Meds

Cost-Cutting Means No Expensive COX-2 Inhibitors
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WebMD Health News

Oct. 28, 2002 -- Rheumatoid arthritis patients probably know it already: Health maintenance organizations (HMOs) are denying access to new medications.

While HMOs usually try to cut costs by cutting back on hospital stays, that's not the case when it comes to RA, according to a new report. It was presented today at the American College of Rheumatology Annual Scientific Meeting in New Orleans.

In a study of RA patients and their treatment, researchers found that HMOs did not restrict outpatient care or hospital admissions for their patients compared with RA patients in other kinds of healthcare plans. Instead, HMOs strived to lower the cost of RA care by reducing the use of medications.

"HMOs do not reduce the use of hospital services or surgery for such patients, so controlling medications may be the way they seek to reduce the costs of treating people with this disease," says researcher Edward Yelin, PhD, professor of medicine and health policy at the University of California, San Francisco, in a news release.

HMOs are restricting payments for expensive new RA medications like COX-2 inhibitors, Yelin says.

"In recent years, several expensive new medications have been approved by the U.S. Food and Drug Administration for the care of individuals with rheumatoid arthritis. This study indicates that rheumatoid arthritis patients in HMOs are much less likely to receive these new medications," Yelin says.

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