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Racial/ethnic differences in the use of biologic disease‐modifying antirheumatic drugs among California Medicaid rheumatoid arthritis patients
Author(s) -
Chu LiHao,
Portugal Cecilia,
Kawatkar Aniket A.,
Stohl William,
Nichol Michael B.
Publication year - 2013
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.21798
Subject(s) - medicine , rheumatoid arthritis , etanercept , adalimumab , logistic regression , infliximab , medicaid , hydroxychloroquine , univariate analysis , sulfasalazine , population , odds ratio , golimumab , physical therapy , multivariate analysis , disease , health care , environmental health , covid-19 , ulcerative colitis , infectious disease (medical specialty) , economics , economic growth
Objective To assess racial/ethnic differences in the use of biologic disease‐modifying antirheumatic drugs (DMARDs) among California Medicaid (Medi‐Cal) rheumatoid arthritis (RA) patients. Methods Medi‐Cal patient level data for 5,385 DMARD recipients between ages 18 and 100 years with at least 1 diagnosis of RA (International Classification of Disease, Ninth Revision, Clinical Modification code 714.xx) and the use of 1 DMARD between January 1, 1998 and December 31, 2005 were collected. The outcome of interest was the choice of either standard DMARDs (methotrexate, lefluonomide, hydroxychloroquine, and sulfasalazine) or biologic DMARDs (adalimumab, etanercept, anakinra, and infliximab). A univariate analysis and logistic regression model were applied to examine the association of the choice of DMARD among different racial/ethnic groups. Results In the univariate analysis, biologic DMARD use was significantly associated with race/ethnicity ( P < 0.001). In the multivariate logistic regression model, after adjusting for age, sex, insurance coverage, 12 comorbid conditions, RA‐related drug prescription, RA‐related inpatient stay, and rehabilitation visits, African Americans had 53% lower odds of receiving biologic DMARDs as compared to whites, whereas Hispanics had 36% increased odds of receiving biologic DMARDs as compared to whites. Conclusion In this Medi‐Cal population, with its racial diversity and relatively homogenous socioeconomic status and health care benefits, racial/ethnic differences were found in RA patients receiving biologic DMARDs.