Value-Based Care in Rheumatology
february 2013 VOL 2 • NO 1
From the publishers of American Health & drug benefits
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www.ValueBasedRheumatology.com
High Out-of-Pocket Cost of Biologic DMARDs for Medicare Patients with RA
Access to a rheumatologist key to appropriate drug therapy By Phoebe Starr
Cost-Effectiveness Helps to Differentiate Drug Classes for Acute Gout Treatment By Wayne Kuznar Washington, DC—Although differences in the effectiveness between different drug classes used in acute gout treatment are small, some treatments offer more value, said Kimberly Reiter, MD, of Presbyterian Medical Group, Albuquerque, NM, at the 2012 meeting of the American College of Rheumatology (ACR). The recent ACR guidelines for the treatment of acute and chronic gouty arthritis indicate that corticosteroids,
colchicine (Colcrys), and nonsteroidal anti-inflammatory drugs (NSAIDs) are appropriate first-line therapies for acute gout. However, according to Dr Reiter, the guidelines do not “go far enough” in ranking the classes of drugs for the treatment of acute gout, nor do they incorporate costs. She presented the findings from a study that compared the drug classes used to treat acute gout flares in terms Continued on page 8
Progress in Classifying and Managing Sjögren’s Syndrome Washington, DC—Medicare beneficiaries who have a low-income subsidy are more likely to have access to rheumatoid arthritis (RA) biolog-
ic therapy through their Part D drug benefit than those who face the Medicare coverage gap (also known as the “donut hole”), according to Continued on page 8
Year in Review, Part 2 By Wayne Kuznar
Washington, DC—In the previous issue of Value-Based Care in Rheumatology, clinical publications of impact from the peer-reviewed literature from late 2011 and 2012 were selected for review by David A. Isenberg, MD, FRCP, FAMS, Arthritis Research Campaign’s Diamond Jubilee Profes-
sor of Rheumatology, University College London, and presented at the 2012 meeting of the American College of Rheumatology. This second article focuses on Dr Isenberg’s selections in translational medicine, as well as a category he called “quirky reports.”
ACR’s proposed new criteria the basis for this development By Phoebe Starr Washington, DC—Sjögren’s syndrome has been understudied and is not well understood, but an international collaboration has produced new classification criteria for this autoimmune disease, and experts are working on guidelines for the management of this condition. These efforts were discussed at the 2012 meeting of the American College of Rheumatology (ACR). The New Criteria New criteria for the classification of
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inside
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VALUE PROPOSITIONS. . . . . . . . . . . New Medicare rules will save providers $676 million annually
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HEALTH ECONOMICS. . . . . . . . . . . . 8 Cost-effectiveness helps differentiate drug classes for acute gout treatment SCLERODERMA. . . . . . . . . . . . . . . . . . Prophylactic use of ACE inhibitors may not be advisable
Rheumatology PRACTICE
Management™. . . . . . . . . . . . . . . . . . .
Exercise program cost-effective for arthritic knee pain © 2013 Engage Healthcare Communications, LLC
Sjögren’s syndrome proposed by the ACR were developed by an international group called the Sjögren’s Syndrome International Collaborative Clinical Alliance (SICCA) and were based on 1362 participants who were enrolled in the SICCA registry. The proposed classification considers that Sjögren’s syndrome is a multisystem autoimmune disease that should involve multidisciplinary treatment in rheumatology, ophthalmology, and oral medicine.
Personalized Medicine in Rheumatology™. . . . . . . . . . . . . . . . . . . .
New genetic loci potential targets for novel therapies for gout
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OSTEOPOROSIS . . . . . . . . . . . . . . . . . Odanacatib effective in women with osteoporosis uncontrolled with alendronate
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DRUG UPDATE. . . . . . . . . . . . . . . . . . Tofacitinib: a new treatment option for patients with RA
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