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Changing Drug Delivery For Rheumatoid Arthritis Patients Increases Effectiveness, Lowers Costs

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SUMMARY: Researchers show that giving the medication, methotrexate, to patients who suffer from juvenile rheumatoid arthritis or rheumatoid arthritis by injection, rather than orally, significantly improved the patients’ health and at a dramatically reduced cost. Researchers report; “We found that 73 percent of patients switched from the oral method to the injection because they were not satisfied with the way they were feeling. Two-thirds of those patients noticed improvement when they got the methotrexate by injection.”

ABSTRACT: Hershey, Pa. — Researchers show that giving the medication, methotrexate, to patients who suffer from juvenile rheumatoid arthritis or rheumatoid arthritis by injection, rather than orally, significantly improved the patients’ health and at a dramatically reduced cost.

“We found that 73 percent of patients switched from the oral method to the injection because they were not satisfied with the way they were feeling. Two-thirds of those patients noticed improvement when they got the methotrexate by injection,” says Barbara Ostrov, M.D., associate professor of pediatrics and medicine at Penn State’s College of Medicine. “When our cost analysis was completed we found that it was 78 percent cheaper for patients to be treated with an injection.”

Ostrov and her colleagues’ paper titled, “Improved Tolerance and Cost-Effectiveness of Subcutaneous Versus Oral Methotrexate in Rheumatoid Arthritis (RA) and Juvenile Rheumatoid Arthritis (JRA),” was presented Nov. 9 at the American College of Rheumatology meeting in San Diego, Calif.

This study involved 52 patients, 36 with RA and 16 with JRA. Patients were on the oral medication for at least three months and then switched and started receiving the methotrexate for at least three months by injection.

Partially because of side effects, such as nausea, 31 percent chose to switch the way they receive their medication. After the change from an oral dose to an injection, only 4 percent still complained of side effects. Also, another third said they switched because of the cost of the oral medication.

Overall, the average cost per patient per week for those treated orally was $16.56. That compares to just $3.57 for those treated by injection. The cost then for treating these 52 patients for one year would be nearly $45,000 compared to less than $10,000 for the group treated by injection.

“When you would extrapolate these costs to a population of 1,000 patients, it would be $861,000 to treat those patients orally compared to $185,000 to treat by injection. These cost savings of $675,000 is dramatic.” states Ostrov.

She adds that at least 1 in every 1,000 people in the United States suffer from rheumatoid arthritis.

Ostrov is a pediatric and adult rheumatologist at the Milton S. Hershey Medical Center in Hershey, Pa. She and her colleagues at Hershey, State College and the Geisinger Medical Center in Danville, Pa., hope to eventually work with a larger group of patients to confirm these studies. Both Hershey Medical Center and the Geisinger Center are part of the Penn State Geisinger Health System.

Source: Hershey Medical Center

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