Table 3.
Multivariable analysis of the odds of abandonment of treatment with ADA by indication
| Characteristic | IBD | RA | PsO | PsA | AS | HS | UV |
|---|---|---|---|---|---|---|---|
| OR (95% CI) | OR (95% CI) | OR (95% CI) | OR (95% CI) | OR (95% CI) | OR (95% CI) | OR (95% CI) | |
| Opt-in to PSPa | 0.28 (0.24–0.34)*** | 0.34 (0.27–0.42)*** | 0.27 (0.20–0.35)*** | 0.34 (0.22–0.52)*** | 0.24 (0.11–0.50)*** | 0.25 (0.14–0.45)*** | 0.18 (0.05–0.67)* |
| Age (years) | 1.01 (1.00–1.02)** | 1.01 (1.00–1.02)* | 1.01 (1.00–1.02) | 1.02 (1.00–1.04)* | 1.02 (0.99–1.04) | 1.01 (0.99–1.04) | 1.05 (1.01–1.10)* |
| Male | 0.78 (0.65–0.92)** | 1.03 (0.82–1.31) | 1.14 (0.90–1.43) | 0.93 (0.64–1.35) | 0.57 (0.32–1.01) | 0.92 (0.51–1.67) | 2.58 (0.89–7.50) |
| Household income | |||||||
| $0–$49,999 | Ref | Ref | Ref | Ref | Ref | Ref | Ref |
| $50,000–$99,999 | 1.03 (0.80–1.32) | 0.66 (0.51–0.86)** | 0.73 (0.52–1.03) | 0.57 (0.33–0.98)* | 1.24 (0.57–2.71) | 0.72 (0.35–1.49) | 1.80 (0.32–10.17) |
| ≥$100,000 | 0.78 (0.60–1.03) | 0.65 (0.48–0.89)** | 0.92 (0.64–1.31) | 0.85 (0.49–1.47) | 0.49 (0.20–1.21) | 0.88 (0.33–2.32) | 1.30 (0.21–7.91) |
| Unknown | 0.92 (0.72–1.18) | 0.75 (0.58–0.98)* | 0.99 (0.71–1.38) | 0.94 (0.55–1.61) | 0.48 (0.20–1.16) | 0.99 (0.50–1.97) | 3.04 (0.58–15.94) |
| Expected patient copay | |||||||
| $0–$25 | Ref | Ref | Ref | Ref | Ref | Ref | Ref |
| $26–$100 | 1.82 (1.45–2.28)*** | 1.74 (1.32–2.31)*** | 2.01 (1.46–2.75)*** | 1.33 (0.77–2.30) | 1.07 (0.46–2.49) | 2.39 (1.20–4.78)* | 1.24 (0.37–4.17) |
| $101–$500 | 1.79 (1.28–2.49)*** | 2.92 (2.03–4.21)*** | 3.10 (2.11–4.55)*** | 3.16 (1.69–5.91)*** | 4.09 (1.37–12.17)* | 2.63 (1.06–6.55)* | 10.85 (2.22–53.04)** |
| $501–$1000 | 3.90 (2.41–6.30)*** | 6.15 (4.11–9.20)*** | 4.19 (2.39–7.36)*** | 7.48 (3.09–18.11)*** | 6.23 (1.75–22.14)** | 2.61 (0.29–23.37) | 55.52 (2.40–999.99)* |
| $1001–$2000 | 5.03 (3.10–8.17)*** | 11.72 (7.78–17.65)*** | 8.13 (4.89–13.50)*** | 13.34 (6.27–28.40)*** | 4.16 (0.76–22.75) | 11.78 (1.79–77.50)* | 2.18 (0.12–38.78) |
| >$2000 | 10.27 (7.95–13.27)*** | 9.60 (6.77–13.61)*** | 9.62 (6.59–14.05)*** | 13.00 (7.37–22.94)*** | 4.85 (1.59–14.79)** | 11.98 (5.31–27.00)* | 4.68 (0.39–55.75) |
| Calendar year | |||||||
| 2015 | 0.83 (0.70–0.99)* | 0.90 (0.73–1.11) | 0.87 (0.68–1.10) | 1.15 (0.75–1.76) | 0.69 (0.37–1.28) | 1.15 (0.68–1.96) | 1.20 (0.43–3.35) |
| 2016 | Ref | Ref | Ref | Ref | Ref | Ref | Ref |
| Primary plan | |||||||
| Commercial | Ref | Ref | Ref | Ref | Ref | Ref | Ref |
| Employer group | 1.33 (0.91–1.92) | 1.33 (0.88–2.00) | 1.60 (0.95–2.68) | 2.30 (1.01–5.25)* | 1.90 (0.58–6.27) | 1.01 (0.36–2.90) | 7.14 (0.74–68.95) |
| TPA | 1.33 (0.38–4.65) | 1.26 (0.37–4.31) | 0.58 (0.11–3.16) | 3.10 (0.24–39.60) | — | 0.93 (0.06–15.01) | — |
| PBM | 1.05 (0.77–1.42) | 1.17 (0.83–1.66) | 0.95 (0.62–1.46) | 1.16 (0.57–2.36) | 1.32 (0.51–3.44) | 0.57 (0.24–1.38) | 7.40 (1.02–53.63)* |
| Cash | 0.53 (0.32–0.87)* | 0.81 (0.47–1.39) | 1.08 (0.57–2.03) | 2.98 (1.13–7.90)* | 2.52 (0.60–10.48) | 0.33 (0.07–1.66) | 4.36 (0.16–120.84) |
| Processors | 1.77 (0.92–3.40) | 1.91 (0.62–5.87) | 1.56 (0.38–6.39) | 2.14 (0.48–9.46) | 0.62 (0.03–12.08) | 0.54 (0.08–3.72) | — |
| Unspecified or missing | 1.20 (0.90–1.59) | 1.20 (0.87–1.67) | 1.10 (0.74–1.63) | 1.51 (0.79–2.92) | 0.52 (0.19–1.41) | 0.46 (0.20–1.07) | 1.67 (0.22–12.58) |
| Initial claim at SP | 0.57 (0.48–0.68)*** | 0.64 (0.53–0.79)*** | 0.73 (0.57–0.93)* | 0.57 (0.39–0.82)** | 0.35 (0.19–0.64)*** | 0.51 (0.29–0.89)* | 1.77 (0.61–5.17) |
| CCI | 0.96 (0.84–1.10) | 1.04 (0.93–1.16) | 0.92 (0.76–1.12) | 1.08 (0.88–1.32) | 1.02 (0.74–1.40) | 1.16 (0.84–1.59) | 0.73 (0.30–1.79) |
Notes: aNon-PSP cohort was the reference. *P<0.05, ** P<0.01, *** P<0.001.
Abbreviations: ADA, adalimumab; AS, ankylosing spondylitis; CCI, Charlson Comorbidity Index; CI, confidence interval; HS, hidradenitis suppurativa; IBD, inflammatory bowel disease; OR, odds ratio; PBM, pharmacy benefit manager; PsA, psoriatic arthritis; PsO, psoriasis; PSP, patient support program; RA, rheumatoid arthritis; Ref, reference; SP, specialty pharmacy; TPA, third party administrator; UV, uveitis.