CHARACTERIZING RESMETIROM INITIATORS IN THE IMMEDIATE POST-APPROVAL PERIOD: ADHERENCE AND PERSISTENCE, AND HEALTHCARE COSTS FROM A US CLAIMS DATABASE
Author(s)
Jyotirmoy Sarker, PhD1, Liang-Yuan Lin, MS2, Mohammad S. Alnuman, BSc, MS3, Aaron N. Winn, MPP, PhD4.
1Department of Pharmacy Administration, University of Mississippi, University, MS, USA, 2University of Mississippi, Oxford, MS, USA, 3University of Illinois at Chicago Department of Pharmacy Systems, Outcomes, and Policy, Chicago, IL, USA, 4University of Illinois at Chicago, Chicago, IL, USA.
1Department of Pharmacy Administration, University of Mississippi, University, MS, USA, 2University of Mississippi, Oxford, MS, USA, 3University of Illinois at Chicago Department of Pharmacy Systems, Outcomes, and Policy, Chicago, IL, USA, 4University of Illinois at Chicago, Chicago, IL, USA.
OBJECTIVES: Resmetirom is the first approved pharmacotherapy for metabolic dysfunction-associated steatohepatitis (MASH) with moderate-to-advanced fibrosis. This study evaluated early post-approval adherence, persistence, healthcare resource utilization (HCRU), and costs among US commercially insured patients initiating resmetirom.
METHODS: We used the Merative MarketScan Commercial Claims and Encounters database to conduct a single-group pre-post retrospective analysis. Adults initiating resmetirom between March 14 and December 31, 2024, with ≥180 days of continuous pre-index enrollment were included. We compared patients’ outcomes 6 months before and after treatment initiation. We examined HCRU and costs (per patient per month [PPPM]) using paired Wilcoxon signed-rank tests for continuous outcomes and McNemar’s test for binary outcomes. Adherence and persistence analyses were restricted to patients with ≥90 days of follow-up. Adherence was defined using a proportion of days covered (PDC) over a fixed 90-day window with stockpile carry-forward, and those with PDC ≥ 80% considered adherent. Persistence was defined as no treatment gap exceeding 30 days over 90 days.
RESULTS: A total of 699 patients met enrollment criteria (mean age 54 years; 54.2% female; median follow-up 98 days). At baseline, hyperlipidemia was present in 58.9%, hypertension in 52.1%, and type 2 diabetes in 45.2%. Post-initiation, outpatient visits decreased (2.47 vs. 2.23 PPPM; p<0.001), as did liver-related outpatient visits (0.57 vs. 0.37 PPPM; p<0.001) and non-resmetirom pharmacy fills (7.26 vs. 3.54 PPPM; p<0.001). Inpatient admission did not differ (2.6% vs. 2.0%; p=0.480). Total costs increased ($5,626 vs. $8,995 PPPM; p<0.001), driven by resmetirom costs; excluding resmetirom, total costs declined ($5,626 vs. $3,004 PPPM; p<0.001). Among 378 eligible patients, adherence was 89.7% and 90-day persistence was 90.2%.
CONCLUSIONS: Although resmetirom raised total pharmacy expenditures, outpatient utilization and costs decreased. Adherence and short-term persistence were high among early initiators. Longer follow-up is needed to assess sustained patterns, clinical impact, and downstream HCRU and costs.
METHODS: We used the Merative MarketScan Commercial Claims and Encounters database to conduct a single-group pre-post retrospective analysis. Adults initiating resmetirom between March 14 and December 31, 2024, with ≥180 days of continuous pre-index enrollment were included. We compared patients’ outcomes 6 months before and after treatment initiation. We examined HCRU and costs (per patient per month [PPPM]) using paired Wilcoxon signed-rank tests for continuous outcomes and McNemar’s test for binary outcomes. Adherence and persistence analyses were restricted to patients with ≥90 days of follow-up. Adherence was defined using a proportion of days covered (PDC) over a fixed 90-day window with stockpile carry-forward, and those with PDC ≥ 80% considered adherent. Persistence was defined as no treatment gap exceeding 30 days over 90 days.
RESULTS: A total of 699 patients met enrollment criteria (mean age 54 years; 54.2% female; median follow-up 98 days). At baseline, hyperlipidemia was present in 58.9%, hypertension in 52.1%, and type 2 diabetes in 45.2%. Post-initiation, outpatient visits decreased (2.47 vs. 2.23 PPPM; p<0.001), as did liver-related outpatient visits (0.57 vs. 0.37 PPPM; p<0.001) and non-resmetirom pharmacy fills (7.26 vs. 3.54 PPPM; p<0.001). Inpatient admission did not differ (2.6% vs. 2.0%; p=0.480). Total costs increased ($5,626 vs. $8,995 PPPM; p<0.001), driven by resmetirom costs; excluding resmetirom, total costs declined ($5,626 vs. $3,004 PPPM; p<0.001). Among 378 eligible patients, adherence was 89.7% and 90-day persistence was 90.2%.
CONCLUSIONS: Although resmetirom raised total pharmacy expenditures, outpatient utilization and costs decreased. Adherence and short-term persistence were high among early initiators. Longer follow-up is needed to assess sustained patterns, clinical impact, and downstream HCRU and costs.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
PCR225
Topic
Patient-Centered Research
Topic Subcategory
Adherence, Persistence, & Compliance
Disease
Gastrointestinal Disorders