Almost Half of Rheumatoid Arthritis Patients Discontinued Xeljanz Within a Year

Adherence programs needed to boost Xeljanz utilization for rheumatoid arthritis.

Nearly half of patients discontinued the use of the rheumatoid arthritis (RA) drug tofacitinib (Xeljanz), after a year of starting treatment, according to an analysis by Prime Therapeutics.

The pharmacy benefit manager analyzed 4.4 million commercially insured members who were continuously enrolled over a 4-year period, from December 2012 to December 2015. Of the members, 887 used Xeljanz during the study period, and 97.2% of those members had a medical claim indicating an RA diagnosis.

Throughout the analysis period, Xeljanz use increased steadily by 10.5 members per month on average.

“Although utilization of Xeljanz is low, it is steadily increasing,” said Pat Gleason, PharmD, director of health outcomes at Prime. “With a lack of long-term safety and efficacy information and a wholesale acquisition cost (WAC) of over $42,000 per year, it is critical to understand real world Xeljanz utilization patterns to best mange the health of our members with rheumatoid arthritis.”

Although Xeljanz is identified as a second-line therapy option in RA patients, 1 in 10 members were using it as a first-line therapy, and did not have a DMARD claim in the year prior to starting Xeljanz treatment.

At the 1-year follow-up, the results of the study showed that 44% of patients discontinued Xeljanz, and more than 30% had discontinued it at 6 months.

“Prime’s research on utilization and adherence patterns of the rheumatoid arthritis drug Xeljanz shows there is opportunity for improvement,” Gleason said. “Care and utilization management programs, as well as outcomes-based contracts with pharmaceutical manufactures, that encourage adherence and the most cost effective treatment strategies, should be considered. These programs should emphasize the use of a nonbiologic DMARD as first line therapy.”