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P449 Patient support program for adalimumab-treated patients with Crohn's disease in Brazil: impact on patients' adherence and persistence

Teich V.*1, Arinelli R.1, Gulart A.1, Chaves L.2, Garg V.2, Skup M.2

1Sense Company, São Paulo, Brazil 2AbbVie Inc., North Chicago, United States

Background

The Brazilian public healthcare system covers treatment with adalimumab (ADA) for multiple indications, including Crohn's disease, in line with local guidelines. Patients treated with ADA in Brazil can opt-in to a patient support program (PSP) called Humanizar offered by AbbVie. The impact of this program on patient outcomes in the Brazilian setting has not been studied previously in patients with Crohn's disease. Here, we evaluate the relationship of PSP enrollment and treatment utilization outcomes (adherence and persistence) among patients with Crohn's disease who initiate ADA.

Methods

Longitudinal data on the utilization of AbbVie's PSP were linked with the Brazilian Health System claims database called DATASUS, which includes all inpatient and outpatient procedures on patients with Crohn's disease who initiated treatment with ADA between 2013 and 2015. Patients using ADA in DATASUS not matched with the AbbVie PSP database were categorized as non-users (non-PSP). Adherence was calculated using proportion of days covered (PDC), defined as the number of months of treatment with ADA divided by the number of months of patient follow-up. Patients were considered adherent if they had a PDC ≥80% [1]. Persistence was calculated as the interval between treatment initiation and treatment discontinuation (defined as a gap of 90 days since the last obtainment of ADA). Adherence and persistence were compared between the PSP and non-PSP cohorts using t tests. Results were segmented for patients with at least 6, 12, and 24 months follow-up.

Results

3,838 patients were included in the analysis: 626 in the PSP cohort and 3,212 in the non-PSP cohort. Patient characteristics were similar between groups: 54% were female, with an average age of 40 years. The percentage of patients with a PDC ≥80% was significantly higher in PSP users compared with non-PSP users at 6, 12, and 24 months follow-up (Table). The average treatment persistence was consistently significantly longer in PSP users compared with the non-PSP cohort at all follow-up time points (PSP vs non-PSP: at 6 months, 5.85 vs 5.73 months; at 12 months, 11.64 vs 11.01 months; at 24 months, 21.89 vs 20.04 months; all p<0.05).

Conclusion

For patients with Crohn's disease, ADA users participating in AbbVie's free-to-patient PSP demonstrated improved adherence and persistence to treatment compared with patients not participating in the PSP.

References:

[1] Brown MT et al, (2011), Mayo Clin Proc, 86:304–14