{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T15:08:19Z","timestamp":1785510499174,"version":"3.56.0"},"reference-count":30,"publisher":"Becaris Publishing Limited","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Comp. Eff. Res."],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:p>\n                    <jats:bold>Aim:<\/jats:bold>\n                    To evaluate the impact of the Taiwan National Health Insurance program policy for advanced rheumatoid arthritis (aRA) therapies on treatment prescription patterns and costs in patients with rheumatoid arthritis (RA).\n                    <jats:bold>Materials &amp; methods:<\/jats:bold>\n                    We performed a retrospective analysis of patients with RA aged \u226518\u00a0years who had commenced aRA treatment in the National Health Insurance research database in Taiwan between 2011 and 2017. Follow-up data were aggregated every 3\u00a0months to determine the proportion of the covered RA prescription days and the medical cost. Associations of the tapering policy initiation in 2014, aRA dose, non-aRA prescription and cost were analyzed using a generalized linear model.\n                    <jats:bold>Results:<\/jats:bold>\n                    In total, 9099 patients with RA were included in this study. Before the policy implementation, the probability of aRA dose tapering increased significantly once treatment duration reached 24\u00a0months, with adjusted odds ratio\u00a0=\u00a03.27 (p\u00a0&lt;\u00a00.001); this further increased to 4.00 (p\u00a0&lt;\u00a00.001) after the policy was implemented. The difference between both adjusted odds ratios was statistically significant (p\u00a0=\u00a00.012). Dose tapering for aRA was associated with reduced medical costs and decreased use of other RA prescription drugs. However, the number of reductions decreased after the dose tapering policy was initiated, suggesting an unintended effect of the policy.\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    The policy implementation increased the dose tapering of aRA prescriptions and was associated with decreased medication costs and the use of other RA treatments. However, a moderate partial offset of the reduction in outcome measures suggests unintended consequences of the policy.\n                  <\/jats:p>","DOI":"10.57264\/cer-2026-0020","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:46:52Z","timestamp":1785422812000},"source":"Crossref","is-referenced-by-count":0,"title":["Effect of dose tapering policy on the prescription of advanced therapy for rheumatoid arthritis: a retrospective analysis of clinical and cost outcomes in Taiwan"],"prefix":"10.57264","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4544-4620","authenticated-orcid":false,"given":"Ko-Jen","family":"Li","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, National Taiwan University Hospital, No. 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei City 10048, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0545-1567","authenticated-orcid":false,"given":"Chao-Hsiun","family":"Tang","sequence":"additional","affiliation":[{"name":"School of Health Care Administration, Taipei Medical University, No. 250, Wuxing Street, Xinyi District, Taipei City 11031, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5418-1840","authenticated-orcid":false,"given":"Chia-Li","family":"Chang","sequence":"additional","affiliation":[{"name":"School of Health Care Administration, Taipei Medical University, No. 250, Wuxing Street, Xinyi District, Taipei City 11031, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6616-6021","authenticated-orcid":false,"given":"Han-Fang","family":"Liao","sequence":"additional","affiliation":[{"name":"Pfizer Ltd., 42 F., No. 100, Songren Rd., Xinyi Dist., Taipei City 11016, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei-Jung","family":"Yen","sequence":"additional","affiliation":[{"name":"Pfizer Ltd., 42 F., No. 100, Songren Rd., Xinyi Dist., Taipei City 11016, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3977-1729","authenticated-orcid":false,"given":"Wen-Yi","family":"Shau","sequence":"additional","affiliation":[{"name":"Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, No.1 Jen Ai road section 1 Taipei 10051, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"36897","reference":[{"issue":"7","key":"e_1_3_11_3_2","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1002\/acr.24596","article-title":"2021 American College of Rheumatology guideline for the treatment of rheumatoid arthritis","volume":"73","author":"Fraenkel L","year":"2021","unstructured":"Fraenkel L, Bathon JM, England BR 2021 American College of Rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis Care Res. 73(7), 924\u2013939 (2021).","journal-title":"Arthritis Care Res."},{"issue":"12","key":"e_1_3_11_4_2","doi-asserted-by":"crossref","first-page":"3331","DOI":"10.1007\/s10067-019-04761-5","article-title":"Management of rheumatoid arthritis: 2019 updated consensus recommendations from the Hong Kong Society of Rheumatology","volume":"38","author":"Ho CTK","year":"2019","unstructured":"Ho CTK, Mok CC, Cheung TT, Kwok KY, Yip RML; Hong Kong Society of Rheumatology. Management of rheumatoid arthritis: 2019 updated consensus recommendations from the Hong Kong Society of Rheumatology. Clin. Rheumatol. 38(12), 3331\u20133350 (2019).","journal-title":"Clin. Rheumatol."},{"issue":"1","key":"e_1_3_11_5_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/art.39480","article-title":"2015 American College of Rheumatology guideline for the treatment of rheumatoid arthritis","volume":"68","author":"Singh JA","year":"2016","unstructured":"Singh JA, Saag KG, Bridges SL Jr 2015 American College of Rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis Rheumatol. 68(1), 1\u201326 (2016).","journal-title":"Arthritis Rheumatol."},{"issue":"6","key":"e_1_3_11_6_2","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1136\/annrheumdis-2019-216655","article-title":"EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update","volume":"79","author":"Smolen JS","year":"2020","unstructured":"Smolen JS, Landew\u00e9 RBM, Bijlsma JWJ EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update. Ann. Rheum. Dis. 79(6), 685\u2013699 (2020).","journal-title":"Ann. Rheum. 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