Exact(2)
Further, among all patients that were initiated on a biologic DMARD, 36% discontinued their index therapy in the 90-day discontinuation gap analysis, as opposed to the 46% identified using a 60-day treatment gap (results not reported).
Variables included: starting dose (first administration or fill), maintenance dose (third administration or fill), average dose, dose escalation, inter-infusion interval, and discontinuation (gap in therapy > 60 days or switch).
Similar(58)
The definition of antidiabetic treatment discontinuation was a gap between two claims of antidiabetic drugs exceeding 6 months.
When the allowed gap for discontinuation was defined as 180 days, median time to discontinuation increased by 0.4 to 4.9 months across all cohorts.
dMaintenance dose defined as the recorded dose of the third administration (infliximab and abatacept) or average daily dose (converted to milligrams per the recommended treatment interval) for the third prescription fill (etanercept and adalimumab) among patients who had at least 3 infusions/fills before discontinuation (> 90 day gap).
Among all patients initiated on an oral nonbiologic DMARD, 51% were calculated to have discontinued their index therapy when using a 90-day treatment gap definition for discontinuation, as opposed to the 58% that discontinued in the study analysis with a 60-day treatment gap (results not reported).
A cut-point of 60 days was utilized as a conservative definition of discontinuation, as patients with gaps of up to 60 days were considered persistent.
In a retrospective study of 32,944 women initiating bisphosphonate treatment, those remaining adherent and persistent had significantly lower total healthcare costs than those with gaps or discontinuation of therapy (Curtis et al 2006).
A discontinuation was assumed when the gap between the first and the second infusion was a) more than 14 plus 60 days, b) more than 28 plus 60 days between the second and third infusion, and c) when the gap between subsequent infusions was more than 56 plus 60 days.
For adalimumab and etanercept we assume that discontinuation takes place when the gap between the perceived end date of a prescription as per label information (e.g. prescription date +14 days for a single adalimumab prescription) and the date of the following prescription was more than 60 days apart.
Being in the Part D gap period increased discontinuation risk: HR = 1.09 (95 % CI: 1.03, 1.16).
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