Comparison of rheumatoid arthritis care costs in patients starting therapywith leflunomide versus etanercept

Objective: To identify differences in rheumatoid arthritis (RA) care costs and utilization among patients receiving therapy with leflunomide (LEF) or etanercept (ETA). Study Design: A retrospective cohort analysis of patients diagnosed with RA and starting treatment with LEF or ETA. Methods: Patients diagnosed with RA and receiving newly prescribed LEF or E TA in 1998 were identified from a database containing patient-level medical and pharmaceutical claims. Patients were subsequently observed for 6 month s. RA-related treatment charges during the observation period were compared between cohorts. Results: A total of 527 LEF- and 281 ETA-treated patients, were identified. The 2 cohorts were comparable with respect to demographics; comorbid condi tions, and concomitant medication use, although LEF recipients were, on ave rage, older than ETA recipients (mean age 52.97 versus 48.43 years; P < .00 01). ETA recipients had higher mean 6-month postdiagnosis charges than LEF recipients ($7722.01 +/- $5285.20 versus $3301.84 +/- $4054.75; P < .0001). This difference was primarily related to differences in RA-related pharmac y charges ($5877.78 $2237.68 versus $1877.23 +/- $1258.05; P < .0001). Conclusions: Compared with charges in the ETA group, RA care costs in the L EF group were significantly lower during the 6 months after the initiation of therapy. The difference in mean total RA-related charges was attributabl e mainly to the difference in RA-related pharmacy charges.