Table 4.
Patient Out-of-Pocket Expenditures and Cost-Sharing Percentage for Patients with RA, 2004–2013
| OOP cost/cost-sharing percentage | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | 2011 | 2012 | 2013 |
|---|---|---|---|---|---|---|---|---|---|---|
| By biologic/nonbiologic DMARD, $ (%) | ||||||||||
| Etanercept | 48 (2.2) | 55 (2.4) | 63 (2.7) | 71 (3.2) | 75 (3.8) | 81 (4.2) | 82 (3.9) | 96 (4.5) | 105 (4.8) | 114 (5.5) |
| Infliximab | 32 (0.9) | 41 (1.4) | 45 (2.2) | 57 (2.3) | 10 (3.6) | 135 (4.6) | 159 (5.3) | 184 (5.9) | 202 (6.1) | 222 (6.6) |
| Anakinra | 15 (4.9) | 14 (5.7) | 24 (7.4) | 26 (11.6) | 22 (12.2) | 18 (11.5) | 19 (10.7) | 35 (15.5) | 35 (14.8) | 34 (14.2) |
| Adalimumab | 47 (1.9) | 58 (2.3) | 62 (2.5) | 67 (2.8) | 71 (3.3) | 78 (3.6) | 71 (3.0) | 86 (3.8) | 115 (5.0) | 123 (5.3) |
| Abatacept | — | — | 22 (11.6) | 36 (2.4) | 68 (4.4) | 90 (5.6) | 110 (6.9) | 121 (7.4) | 134 (7.7) | 147 (8.2) |
| Rituximab | — | — | 70 (1.5) | 85 (1.8) | 11 (2.4) | 213 (4.2) | 268 (5.3) | 268 (5.5) | 322 (6.5) | 374 (7.5) |
| Golimumab | — | — | — | — | — | 70 (2.9) | 77 (3.1) | 86 (3.5) | 96. (4.0) | 107 (4.6) |
| Certolizumab | — | — | — | — | — | 58 (2.2) | 51 (2.1) | 88 (3.6) | 97 (4.1) | 97 (4.4) |
| Tocilizumab | — | — | — | — | — | — | — | 106 (7.4) | 123 (8.1) | 137 (8.9) |
| Tofacitinib | — | — | — | — | — | — | — | — | 46 (2.1) | 89 (4.7) |
| By insurance plan type, $ (%) | ||||||||||
| EPO | 37 (1.4) | 47 (2.2) | 48 (2.2) | 50 (2.3) | 68 (2.9) | 66 (3.3) | 70 (3.5) | 78 (3.7) | 83 (3.8) | 93 (4.2) |
| PPO | 52 (2.5) | 51 (2.1) | 59 (2.8) | 62 (3.3) | 69 (5.9) | 77 (5.9) | 78 (3.4) | 89 (3.9) | 107 (4.6) | 117 (5.4) |
| POS | 63 (2.6) | 79 (4.0) | 97 (8.1) | 96 (8.5) | 102 (7.3) | 104 (7.0) | 102 (7.2) | 104 (7.4) | 110 (6.5) | 121 (7.1) |
| FFS | 39 (1.9) | 49 (2.2) | 58 (2.5) | 65 (2.9) | 82 (3.7) | 97 (4.3) | 95 (4.4) | 114 (5.1) | 131 (5.8) | 141 (6.4) |
| HMO | 39 (1.8) | 49 (2.1) | 48 (2.2) | 67 (3.0) | 81 (3.6) | 91 (4.0) | 104 (4.9) | 125 (5.8) | 138 (6.2) | 151 (6.7) |
| Other | 37 (1.5) | 42 (1.9) | 76 (3.2) | 82 (3.6) | 125 (5.6) | 109 (4.7) | 109 (5.3) | 152 (6.9) | 170 (7.2) | 180 (8.0) |
DMARD indicates disease-modifying antirheumatic drug; EPO, exclusive provider organization; FFS, fee for service; OOP, out-of-pocket; POS, point of service; RA, rheumatoid arthritis.