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Rheumatoid Arthritis Drugs Are Underused

Study Shows RA Drugs Known as DMARDs Aren’t Prescribed as Aggressively as They Should

The Importance of DMARDs continued...

Treatment varied dramatically among health care plans, according to the researchers.

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

The researchers did not investigate the causes of variations in treatment but speculate the some health plans may have different policies about when patients can see certain types of specialists.

Or Schmajuk says, “one health care plan might have one rheumatologist for 5,000 patients versus another that provides one for every 500 patients.”

In some cases there may be medical reasons why RA patients are not taking DMARDs, such as possible interactions of the medications with other drugs. Also, the study suggests co-payments for DMARDs may have an impact on the number of people being prescribed the drugs.

“Given the enormous individual and societal costs associated with RA, and increasing substantial evidence that DMARDs can reduce these costs, variations in DMARD receipt based on demographics, socioeconomic status and geography are unacceptable,” the researchers write. “Because optimizing DMARD use is the primary mechanism for decreasing the significant public health impact of RA in the United States, targeting educational and quality improvement interventions to patients who are under using DMARDs and their clinicians will be important to eliminate these disparities.”

The researchers say people with RA and their health care providers need to be more aware of the benefits of DMARDs.

The study is published in the Feb. 2 issue of the Journal of the American Medical Association.

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