OBJECTIVES: To assess characteristics of patients with rheumatoid arthritis (RA) treated with at least one ambulatory prescription for a disease-modifying antirheumatic drugs (DMARDs) per the Healthcare Effectiveness Data and Information Set’s (HEDIS) DMARD Therapy for Rheumatoid Arthritis measure.

METHODS: This retrospective observational study utilized claims from a large national health plan. Following HEDIS measure technical specifications, we identified patients 18-89 years of age with continuous enrollment during 2014. We required ≥2 claims for an RA outpatient visit and/or discharge on different dates between January and November, 2014. Patients’ characteristics were analyzed and differences between patients treated and not treated with DMARDs were evaluated using descriptive statistics.

RESULTS: A total of 33,880 patients fulfilled all study criteria and 25,483 (75.2%) received DMARDs during 2014. Patients treated with DMARDs were younger [mean +/- standard deviation (SD): 67 years +/- 10.7 vs. 69 years +/-10.7], healthier (Deyo Charlson Comorbidity index mean +/- SD: 2.4 +/- 1.9 vs. 2.6 +/- 2.1) and were comprised of a greater proportion of women (75.9% vs. 71.0%) than those not treated with DMARDs, p<0.0001. A greater proportion of patients treated with DMARDs (p<0.0001) had biomarker tests such as Cyclic Citrullinated Peptide antibody (19.6% vs. 15.1%), C-reactive protein (62.1% vs. 34.8%), and erythrocyte sedimentation rate (69.7% vs, 43.4%) compared with those not treated with DMARDs. Patients treated with DMARDs had shorter time between their RA-related visits than patients not treated with DMARDs (49.5 days +/- 49 vs. 64.9 days +/- 61.6, p < 0.0001).

CONCLUSIONS: Despite the evidence supporting the effectiveness of DMARDs in treating RA, a quarter of patients with RA were not treated with DMARDs in this population during 2014. Findings from this study suggest that patients treated with DMARDs are younger in age, with fewer comorbidities and receiving intensive care (biomarker tests and RA-related visit frequency).