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As more biologics are approved, there is increasing interest in comparative effectiveness research (CER). Health insurance claims databases have encounter data but seldom contain clinical outcomes. A recently published algorithm assessed the clinical effectiveness of RA biologics using VA claims data and validated against the DAS28ESR[1] had a sensitivity, 72% (95% CI = 67- 77%) and specificity, 91% (95% CI = 89- 93%). The accompanying editorial [2] commented, "A claims-based effectiveness algorithm with acceptable performance characteristics across different data settings will be a powerful and desired tool for CER of RA. Such an algorithm will enable large-scale, population-based studies comparing the effectiveness of different DMARD regimens. Such studies will facilitate head-to-head comparisons, supplementing typical randomized controlled trials and prospective registries that usually include disease activity...Whether the algorithm will have a similar performance in other claims databases therefore needs to be further examined". We performed an independent analysis to evaluate the algorithm's positive predictive value (PPV) in a commercial claims data source compared to a clinical gold standard.

Further evaluation of a claims-based algorithm to determine the effectiveness of biologics for rheumatoid arthritis using commercial claims data