{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T12:08:08Z","timestamp":1747224488739,"version":"3.40.5"},"reference-count":34,"publisher":"PAGEPress Publications","issue":"1","license":[{"start":{"date-parts":[[2021,4,19]],"date-time":"2021-04-19T00:00:00Z","timestamp":1618790400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Reumatismo"],"abstract":"<jats:p>Objective. To provide estimates of patients with rheumatoid arthritis (RA) eligible for biotechnological therapy and to evaluate their healthcare costs. Method. An observational analysis was performed based on data-linkage between administrative databases of selected Italian Regional\/Local healthcare departments. Data were then re-proportioned to the Italian population. Patients with RA diagnosis defined by discharge diagnosis and\/or exemption code during 01\/01\/2013- 31\/12\/2017 were included. The criteria applied to evaluate the elegibility for biotechnological therapy were: 1) methotrexate (MTX)-treatment failure \u22656 months and start of a different conventional-synthetic diseasemodifying antirheumatic drugs (csDMARD); 2) corticosteroid \u22656 months with dosage \u22657.5 mg\/die; 3) MTX-contraindication (therapy or hospitalization for renal damage\/interstizial lung disease\/hepatic failure). Mean annual costs per patient included drugs, hospitalizations, outpatient services. Results. Data re-proportioned to the Italian population estimated 318,328 RA patients: 43,361 with, 274,967 without biotechnological agents. Among the latter, 26,487(9.6%) patients met \u22651 criteria applied for eligibility: 1,896 had MTX-treatment failure and started another csDMARD; 15,833 received corticosteroid \u22657.5 mg\/die; 7,788 had MTX-contraindication. Regarding patients fulfilling two criteria, 107 had MTX-treatment failure followed by another csDMARDs and corticosteroid \u22657.5 mg\/die, 53 were treated with another csDMARDs after MTX-treatment failure and also presented MTX-contraindication, 810 had corticosteroid \u22657.5 mg\/die and MTX-contraindication. Mean total annual costs for patients estimated eligible for biotechnological therapy was \u20ac 3,132, of which \u20ac 177 related to drugs indicated for RA and \u20ac 2,955 related to other direct costs. Conclusions. According to our estimates, around 10% RA patients not currently treated with biotechnological agents are eligible for such therapies, highlighting a trend of under-use in clinical practice for RA management.<\/jats:p>","DOI":"10.4081\/reumatismo.2021.1329","type":"journal-article","created":{"date-parts":[[2021,4,20]],"date-time":"2021-04-20T07:06:27Z","timestamp":1618902387000},"page":"5-14","source":"Crossref","is-referenced-by-count":1,"title":["Assessment of patients affected by rheumatoid arthritis eligible for biotechnological agents and evaluation of their healthcare resource utilization and related costs"],"prefix":"10.4081","volume":"73","author":[{"given":"L.","family":"Degli Esposti","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5018-490X","authenticated-orcid":false,"given":"V.","family":"Perrone","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3272-8755","authenticated-orcid":false,"given":"D.","family":"Sangiorgi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Sinigaglia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2549","published-online":{"date-parts":[[2021,4,19]]},"reference":[{"key":"21","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)30173-8"},{"key":"22","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-204627"},{"key":"23","unstructured":"Pahwa R, Singh A, Jialal I. Chronic Inflammation. In: StatPearls (Internet). Treasure Island (FL): StatPearls Publishing; 2020 (cited 2020 Feb 12). Available from: http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK493173\/"},{"key":"24","unstructured":"WHO. Chronic rheumatic conditions (Internet). WHO. (cited 2020 Feb 12). Available from: http:\/\/www.who.int\/chp\/topics\/rheumatic\/en\/"},{"key":"25","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-014-2974-6"},{"key":"26","doi-asserted-by":"publisher","DOI":"10.2147\/CEOR.S91006"},{"key":"27","doi-asserted-by":"publisher","DOI":"10.1038\/s41413-018-0016-9"},{"key":"28","doi-asserted-by":"publisher","DOI":"10.3390\/jcm8070938"},{"key":"29","unstructured":"Silvagni E, Di Battista M, Bonifacio AF, et al. One year in review 2019: novelties in the treatment of rheumatoid arthritis. Clin Exp Rheumatol. 2019; 37: 519-34."},{"key":"30","unstructured":"Smolen JS, Landew\u00e9 RBM, Bijlsma JWJ, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update. Ann Rheum Dis. 2020; annrheumdis-2019-216655."},{"key":"31","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2019.102421"},{"key":"32","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-019-04727-7"},{"key":"33","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-017-0578-8"},{"key":"34","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-210715"},{"key":"35","unstructured":"Agenzia Italiana del Farmaco (AIFA). Guideline for the classification and conduction of the observational studies on medicines. (Internet) 2010. Available from: https:\/\/www.agenziafarmaco.gov.it\/ricclin\/sites\/default\/files\/files_ wysiwyg\/files\/CIRCULARS\/Circular%2031st%20May%202010.pdf"},{"key":"36","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001885"},{"key":"37","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-006029"},{"key":"38","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-021447"},{"key":"39","doi-asserted-by":"publisher","DOI":"10.1007\/s40744-016-0034-2"},{"key":"40","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2011.05.044"},{"key":"41","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2009.126573"},{"key":"42","doi-asserted-by":"crossref","unstructured":"Chen Y-F, Jobanputra P, Barton P, et al. A systematic review of the effectiveness of adalimumab, etanercept and infliximab for the treatment of rheumatoid arthritis in adults and an economic evaluation of their cost-effectiveness. Health Technol Assess. 2006; 10: iii\u2013iv, xi\u2013xiii, 1\u2013229.","DOI":"10.3310\/hta10420"},{"key":"43","unstructured":"Miltenburger C, G\u00fcnther OH, Justo N, et al. A Survey of barriers to treatment access in rheumatoid arthritis (Internet). 2009 (cited 2020 Feb 14) p. 29. Available from: http:\/\/www.comparatorreports.se\/RA%20Barrier%20Report_FINAL_050110.pdf"},{"key":"44","unstructured":"Federfarma. Farmaci biologici, in Italia poco utilizzati. I dati della Sir (Internet). (cited 2020 Feb 14). Available from: https:\/\/federfarma.it\/Edicola\/FiloDiretto\/VediNotizia.aspx?id=19547"},{"key":"45","unstructured":"Malattie autoimmuni: un esercito di 200mila pazienti senza accesso ai biologici (Internet). Italian Biosimilars Group. (cited 2020 Feb 13). Available from: http:\/\/www.italianbiosimilarsgroup.it\/it\/area-stampa\/in-primo-piano\/158-malattie-autoimmuni-un-esercito-di-200mila-pazienti-senza-accesso-ai-biologici.html"},{"key":"46","doi-asserted-by":"publisher","DOI":"10.5301\/GRHTA.5000194"},{"key":"47","unstructured":"D\u2019Ambrosio G. Primo Rapporto Sociale sull\u2019Artrite reumatoide in Italia SIR-ANMAR-Censis (Internet). Anmar Italia ONLUS. (cited 2020 Feb 13). Available from: http:\/\/www.anmar-italia.it\/news-doc\/anmar-istituzioni\/202-primo-rapporto-sociale-sullartrite-reumatoide-in-italia-sir-anmar-censis"},{"key":"48","unstructured":"Fedele D, Marra A, Carletti R, Scanavacca P. Cost-effectiveness analysis of drugs biological in rheumatoid arthritis. 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