OBJECTIVES: To describe medication utilization among newly diagnosed rheumatoid arthritis (RA) patients. METHODS: A retrospective analysis of administrative claims identified individuals within a large manufacturing company with continuous eligibility for a four-year time frame (2001-2008), using one year as a pre-index period and 3 years for follow-up.  New RA patients age 18-62 were identified as (1) free of any medical claims with ICD9 code of 714.xx with no biologic or non-biologic disease modifying anti-rheumatic drugs (DMARDs) in pre-index year; (2) having at least 2 separate medical claims with ICD9 code of 714.xx in the index year. The first claim date was designated as the index date.  Patients’ pharmacy claims for all possible RA medications were followed for 3 years starting from the index date. RESULTS: Among 1769 new RA patients in the study, 69% were females. Average age was 55 in the index year.  During the index year, 30% (N=521) of patients started biologic or non-biologic DMARD treatment, 56% (N=985) received pain medications but no DMARDs, and 14% (N=263) did not have prescriptions for either DMARDs or pain medications.  However, in year 3, 25% (N=444) received DMARDs, 47% (N=838) received pain medications only, and 28% (N=487) did not have prescriptions for either.  Among 521 who started DMARD treatment in Year 1, 71% (N=368) remained on DMARDs in Year 2, and 58% (N=300) remained on DMARDs for all 3 years. CONCLUSIONS: In the first 3 years of onset of RA, 25-30% of patients received biologic or non-biologic DMARD treatments in each year. Most patients starting DMARDs stay on treatment for multiple years.  A substantial portion of patients, however, do not remain on DMARD treatment.  This demonstrates that unmet needs may remain with currently available biologic and non-biologic DMARDs.  Future research should differentiate utilization patterns of biologic and non-biologic DMARDs.