{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T14:58:00Z","timestamp":1740149880586,"version":"3.37.3"},"reference-count":22,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2016,2,18]],"date-time":"2016-02-18T00:00:00Z","timestamp":1455753600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001868","name":"Taiwan National Science Council","doi-asserted-by":"crossref","award":["NSC-99-2410-H-010-001"],"award-info":[{"award-number":["NSC-99-2410-H-010-001"]}],"id":[{"id":"10.13039\/501100001868","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Cheng Hsin Hospital, Taipei, Taiwan"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>The biologics used to treat rheumatoid arthritis (<jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>) patients with a catastrophic illness certificate have been free without co\u2010payment since 2003 in Taiwan. The purpose of this study was to explore the trend of health care expenditures and the cost of biologics for the treatment of <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> patients between 1999 and 2009.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study used a specially requested nation\u2010wide <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> patient claim dataset from National Health Insurance program. We identified all patients by both the primary diagnosis code <jats:styled-content style=\"fixed-case\">ICD<\/jats:styled-content>\u20109\u2010<jats:styled-content style=\"fixed-case\">CM<\/jats:styled-content> 714.0 and the catastrophic illness certificate for <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>. A total of 30 013 patients were recorded in the treated <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> cohort from 1999 to 2009.The growth rates before and after introducing biologics were compared and tested.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We found that from 1999 to 2009 the adjusted incidence rate for <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> stably increased. Drug costs accounted for 53.2\u201370.3% of the total medical cost during the study period. There was a significant increase in biologics cost, climbing rapidly from 2.8% in 2003 to 60.4% of the total drug cost in 2009. The growth rate of outpatient drug costs was much higher after the introduction of biologics (2003\u20132009), which was 207.8% versus 42.0% as compared to the earlier period (1999\u20132002). Biologics such as etanercept, adalimumab and rituximab, were the crucial factors responsible for this increase in drug cost.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The financial impact of adopting new biologics on healthcare costs is a critical issue that needs to be addressed by the National Health Insurance.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1756-185x.12813","type":"journal-article","created":{"date-parts":[[2016,2,18]],"date-time":"2016-02-18T23:37:38Z","timestamp":1455838658000},"page":"1112-1118","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The impact of introducing biologics to patients with rheumatoid arthritis in <scp>T<\/scp>aiwan: a population\u2010based trend study"],"prefix":"10.1111","volume":"19","author":[{"given":"Hui\u2010Chu","family":"Lang","sequence":"first","affiliation":[{"name":"Institute of Hospital and Health Care Administration National Yang\u2010Ming University Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hou\u2010Ching","family":"Lee","sequence":"additional","affiliation":[{"name":"School of Public Health National Defense Medical Center Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinn\u2010Shing","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Medicine \u2013 Allergy, Immunology and Rheumatology Cheng Hsin Hospital Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hsiao\u2010Yi","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Allergy, Immunology and Rheumatology Taipei Veterans General Hospital and School of Medicine National Yang\u2010Ming University Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying\u2010Ming","family":"Chiu","sequence":"additional","affiliation":[{"name":"Division of Allergy, Immunology and Rheumatology Changhua Christian Hospital Changhua Taiwan"},{"name":"Department of Nursing College of Medicine and Nursing Hungkuang University Taichung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,2,18]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/ar2669"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-012-2411-7"},{"issue":"2","key":"e_1_2_8_4_1","first-page":"302","article-title":"Prevalence of rheumatic diseases in Taiwan: a population study of urban, suburban, rural differences","volume":"21","author":"Chou CT","year":"1994","journal-title":"J Rheumatol"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0049-0172(91)90046-3"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0049-0172(00)80017-7"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.2165\/00019053-200422001-00002"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/occmed\/kqi171"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/03009749950155319"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.11358"},{"key":"e_1_2_8_11_1","unstructured":"Bureau of National Health Insurance Taiwan2014. 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