POS0551 MEDICAL COSTS FOR PATIENTS STARTING TREATMENT FOR RHEUMATOID ARTHRITIS WHO HAVE COMORBID DIABETES MELLITUS IN JAPAN

Background: Rheumatoid arthritis (RA) patients can experience various comorbidities 1 . The incidence of diabetes mellitus (DM) is reported higher in with RA 2 and comorbid DM likely to affect treatment outcomes 3 then healthcare resource uses, however, no previous study has not focused on it. Objectives: To evaluate medical costs use starting for without using a large claims database Japan. Methods: We used Japanese administrative constructed by the Japan Medical Data Center (JMDC) 4 Patients International Classification Diseases 10th revision (ICD-10) codes who started medication disease-modifying antirheumatic drugs (DMARDs) after 6 months them period from 1/1/2012 12/31/2017 were observable 12 as follow-up enrolled. These categorized or non-DM group ICD-10 plus antidiabetic before DMARDs (baseline period). adjust baseline characteristics between groups, they matched sex, age, Charlson Comorbidity Index (CCI) except DM, first DMARDs, medications. primary endpoint was mean cost per patient 12-month period. Costs JPY converted into EUR (1 = 125 2020). drugs, treatments, materials their subcategories evaluated both DM-specific costs. secondary endpoints proportions each resource. Results: 161 2,974 eligible, 109 group. medians age CCI 59 years 2.0 groups significant difference observed all matching groups. Total significantly (DM, 5,331 EUR, 3,200 EUR; P< 0.05). After excluding costs, drug than (DM 1,883 896 P < 0.05), especially biological 1,156 292 mainly because proportion these (Table 1). Treatment 2,380 2,133 EUR) material 74 149 different but only examinations 970 779 Table 1. Number Type Drug use, n (%) (N 109) Non-DM -value csDMARDs (100.0) 1.000 Methotrexate 101 (92.7) 102 (93.6) Others 46 (42.2) 51 (46.8) 0.583 bDMARDs 16 (14.7) (5.5) 0.041 TNFi 11 (10.1) (3.7) 0.118 IL6i (1.8) 0.219 T-cell 0 (0.0) 0.125 tsDMARDs CSs 65 (59.6) 62 (56.9) 0.711 Analgesics 103 (94.5) 96 (88.1) 0.167 Acetaminophen 24 (22.0) 23 (21.1) /Opioids 10 (9.2) 0.454 NSAIDs 93 (85.3) 0.093 Opioids 25 (22.9) 17 (15.6) 0.185 bDMARDs=biological drugs; CSs=corticosteroids; csDMARDs=conventional synthetic DM=diabetes mellitus; IL6i=interleukin-6 inhibitor; NSAID=non-steroidal anti-inflammatory drug; T-cell=selective co-stimulation modulator; TNFi=tumor necrosis factor α tsDMARDs=targeted P-values calculated McNemar test Conclusion: more prevalent References: [1]Gabriel SE et al., Arthritis Res Ther 2009;11(3):229. [2]Giacomelli R Expert Rev Clin Immunol 2016;12(8):849-55. [3]Crepaldi G PLoS One 2016;11(1):e0146991. [4]JMDC database, Tokyo, Disclosure Interests: Eiichi Tanaka Speakers bureau: AbbVie GK, Asahi Kasei Pharma Corporation, Astellas Inc, Ayumi Pharmaceutical Chugai Co., Ltd., Eisai Eli Lilly K.K., GlaxoSmithKline Kyowa Chemical Janssen Mochida Pfizer, Takeda Ltd, Teijin Eisuke Inoue Pfizer Japan, Bristol-Myers Squibb Ryoko Sakai Bristol Myers Grant/research support from: Tokyo Women’s University (TWMU), particularly Division Multidisciplinary Management Rheumatic Diseases, Department Rheumatology, received unrestricted research grants Co.; Ltd.; Nippon Kayaku Taisho Toyama Mitsubishi Tanabe which TWMU paid salaries RS., Iwasaki Katsuhiko: None declared, Ayako Shoji: masayoshi harigai Inc., Consultant of: Gilead Sciences Corp., Ltd. Daiichi-Sankyo, Corporation.,