• Fiorenzo Santoleri, Ruggero Lasala, Paolo Abrate, Laura Pestrin, Enrico Pasut, Germana Modesti, Felice Musicco, Chiara Fulgenzio, Eva Zuzolo, Gabriella Pieri, Martina Roperti, Pietro Gazzola, Marco Gambera, Isabella Martignoni, Valentina Montresor, Francesco De Vita, Francesca Guarino, Laura Grossi, Letizia Di Fabio, Cristina Roberti, Concetta Spoltore, Gabriella Tinari, Stefania De Rosa, Romina Giannini, Roberto Langella, Grazia Mingolla, Mariantonietta Piccoli, and Alberto Costantini.
• Pescara General Hospital, Pescara, Italy.
• Curr Med Res Opin. 2023 Dec 1; 39 (12): 172917351729-1735.

ObjectivesThe objective was to assess the adherence, persistence, and costs of bDMARDs through a multicentre study of nine Italian hospital pharmacies.MethodsThe drugs analysed were Abatacept, Adalimumab, Certolizumab, Etanercept, Golimumab and Tocilizumab.Adult subjects with Rheumatoid Arthritis were considered in the analysis.In this study, we calculated the following metrics: Adherence to treatment was evaluated as dose-intensity, which is the ratio between the amount of medication received and probably taken by the patient at home (Received Daily Dose, RDD) and the amount prescribed by the clinician (Prescribed Daily Dose, PDD). Persistence was calculated as the number of days between the first and last dispensing of the same drug. Lastly, costs were assessed based on persistence to treatment and normalized for adherence.ResultsAdherence to treatment was found to be above 0.8 for all drugs studied. The median persistence for a 5-year treatment period was 1.4 years for Abatacept, 1.7 years for Adalimumab, 1.8 years for Certolizumab, 1.4 years for Etanercept, 1.3 years for Golimumab, and 1.6 years for Tocilizumab.ConclusionsThis multicentre retrospective observational study of bDMARDs used in the treatment of RA showed that, for all the drugs studied, there was no problem with adherence to treatment but rather a difficulty in maintaining treatment with the same drug over time.

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