OBJECTIVES: Rheumatoid arthritis (RA) is a chronic autoimmune disorder that affects small joints of the hands and feet. It usually results in swollen and painful joints. In severe cases, there may be lethargy and weakness which progresses within months. Despite the progress in the area of Rheumatoid Arthritis in terms of prognosis, drug response and treatment modalities can be erratic. Patients are typically switched to agents with similar action and efficacy. This study is aimed at determining the number and proportion of rheumatoid arthritis patients with a new start of a DMARD, switching to another DMARD within a 6 and12 month period. METHODS: This study is a retrospective analysis of a cohort of Rheumatoid Arthritis patients This study will utilize the Mississippi Medicaid administrative claims database. Patients must be ≥ 18 years identified through a diagnosis of Rheumatoid arthritis with ICD 9 code (714.xx) and ICD 10 code (M06.9). The index date will be the date of a new start for a DMARD within the time period and continuous eligibility in Medicaid for 6 months would be the pre index period The primary outcome of interest would be to determine the number patients that change from their current DMARD to another within the time frames – 6months and 12 months following initial therapy. Patients must also be DMARD naïve prior to study. RESULTS: