Age, Race, and Wealth Affect Arthritis Drug Receipt

Demographics, socioeconomic status, geographic location, and health care plan all involved

TUESDAY, Feb. 1 (HealthDay News) -- Among Medicare-managed rheumatoid arthritis (RA) patients, receipt of disease-modifying antirheumatic drugs (DMARDs) varies based on demographic and other factors, according to a study published in the Feb. 2 issue of the Journal of the American Medical Association.

Gabriela Schmajuk, M.D., from Stanford University in California, and colleagues analyzed individual-level data from the health-effectiveness data and information set (HEDIS) for 93,143 patients aged 65 or older, who had at least two RA diagnoses within a year between 2005 and 2008. Factors associated with DMARD receipt were determined.

The investigators found that overall performance on the HEDIS for RA was 59 percent in 2005, and that it increased to 67 percent in 2008. The largest factor in this increase was age. Patients aged 85 and older had a significantly lower rate of DMARD receipt compared with patients aged 65 to 69. Lower DMARD rates were found to be associated with sex (male), race (black), low personal income, lowest zip-code-based socioeconomic status, enrollment in for-profit health plans, and location in the Middle or South Atlantic region, compared with the Pacific region.

"We found significant differences in DMARD receipt based on individual, community, and health plan characteristics. Given the enormous individual and societal costs associated with RA, and increasing substantial evidence that DMARDs can reduce these costs, variations in DMARD receipt based on demographics, socioeconomic status, and geography are unacceptable," the authors write.

One author disclosed financial relationships with Merck and Pfizer.

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