Biotechnology Healthcare - July/August 2008 - (Page 16)

AT A GLANCE Rheumatoid Arthritis: Prevalence, Economics, And Implications for Payers and Purchasers Lola Butcher, Contributing Editor R heumatoid arthritis, a chronic autoimmune inflammatory disease, generally leads to significant pain, joint destruction, and functional decline. It is a significant cause of work disability. Although RA does not have a predictable progression, most patients with the disease require ongoing medical treatment to control symptoms. EXTENT OF DISEASE Prevalence estimates The National Arthritis Data Workgroup of the U.S. Centers for Disease Control and Prevention reported this year that 1.3 million American adults have physiciandiagnosed RA.1 The prevalence of RA among women in 2005 was approximately double that of men. DRUGS IN DEVELOPMENT Biotechnology products in pipeline The advent of biologic disease-modifying antirheumatic drugs has rejuvenated drug development for agents to treat RA. In all, 65 RA treatments are in development. Total number of RA therapies in development Number (% of total in development) Prevalence by sex Women 35 (54%) 22 (34%) 36.5% 63.5% Men 5 (8%) 1 (2%) Clinical Phase 1 Phase 2 Phase 3 2 (3%) Preregistration Source: Helmick 2008 Et cetera: Estimates of RA prevalence in 2005 were down significantly from a 1990 estimate of 2.1 million. Rochester data1 were used to develop both estimates. The lower estimate reflects a more restrictive definition of RA — diagnosed by a physician (earlier estimates included people with chronic joint symptoms) — and wellestablished declines in RA prevalence around the world. Sources: PhRMA 2006, 2008 Et cetera: The two drugs awaiting FDA approval as of July — certolizumab pegol (Cimzia) and tocilizumab (Actemra) — are both biologics. Of the five RA therapies in phase 3 trials, two — golimumab and ocrelizumab — are biologics. If all are approved, it would bring to 10 the number of biologics on the market to treat RA — by far, the therapeutic area with the most biologic choices. CLINICAL BURDEN Comorbidity and mortality People with RA have reduced life expectancy and, in particular, die from heart-related problems at higher rates than people without RA. A study that followed 1,010 British RA patients for more than a decade found cardiovascular disease to be the most frequent cause of death. Standardized mortality ratios Women, number of deaths Standardized mortality ratio 1.84 1.93 1.95 1.77 2.18 Men, number of deaths Standardized mortality ratio 1.45 1.36 1.46 1.38 1.79 Observed All causes Cardiovascular disease Ischemic heart disease Myocardial infarction Respiratory problems Source: Goodson 2005 Expected 179 82 43 26 23 Observed 142 62 42 26 26 Expected 98 45 29 19 15 328 158 83 47 51 Et cetera: It is unclear whether the increase in cardiovascular mortality reflects the health-risk profile of people with RA (e.g., higher rates of concomitant hypertension or tobacco use), or the effects of drugs used to treat the condition. 16 BIOTECHNOLOGY HEALTHCARE · JULY/AUGUST 2008

Table of Contents Feed for the Digital Edition of Biotechnology Healthcare - July/August 2008

Biotechnology Healthcare - July/August 2008 Openers Contents Editorial/David B. Nash, MD, MBA Drug Track Health Plan Confidential Rheumatoid Arthritis A Decade of Trial, Error, False Starts, and Hope What Path Will Comparative Effectiveness Research Take? RA Therapies in Development: A New Generation of Relief Assessing the Full Impact of RA on Employers and Payers Stem Cells: Health Insurance You Can Bank On Specialty Pharmacy Employer to Employer Personalized Medicine Trends Clinical Briefs

Biotechnology Healthcare - July/August 2008

For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.