Association of Patient, Prescriber, and Region With the Initiation of First Prescription of Biologic Disease-Modifying Antirheumatic Drug Among Older Patients With Rheumatoid Arthritis and Identical Health Insurance Coverage

Key Points Question What patient, prescriber, and regional factors are associated with time to first prescription of biologic disease-modifying antirheumatic drug (DMARD) among patients 67 years or older with rheumatoid arthritis? Findings In this cohort study of 17 672 older patients with rheumatoid arthritis, patients were more likely to receive biologic DMARDs earlier if they were younger, female, and living in urban areas closer to prescribers. Physician preference was strongly associated with differences in time from first conventional synthetic DMARD to first biologic DMARD. Meaning In this study, pharmacologic care for rheumatoid arthritis was not uniform across patients and prescribers given similar disease characteristics in a population with identical health insurance coverage.