Clinical Utility and Cost Savings in Predicting Inadequate Response to Anti-TNF Therapies in Rheumatoid Arthritis

Area of Science:

• Rheumatology
• Clinical Immunology
• Health Economics

Background:

• The PrismRA® test is designed to identify rheumatoid arthritis (RA) patients who are unlikely to respond to anti-tumor necrosis factor (anti-TNF) therapies.
• Evaluating the clinical and financial impact of integrating PrismRA into standard RA patient care is crucial.

Purpose of the Study:

• To assess the clinical and economic outcomes of incorporating the PrismRA test into routine care for rheumatoid arthritis (RA) patients.
• To compare treatment strategies with and without PrismRA guidance for first-line biologic therapy.

Main Methods:

• A decision-analytic model was developed to evaluate 12-month clinical and economic outcomes after initiating first biologic treatment.
• Two strategies were compared: observed clinical decisions versus modeled decisions using PrismRA results to guide first-line biologic choice after csDMARD failure.
• Modeled costs included biologic and non-biologic pharmacy, and total medical expenses.

Main Results:

• Using PrismRA to predict inadequate responders to anti-TNF therapies increased modeled ACR50 response to first-line biologics by 38%.
• The PrismRA-stratified population showed a 33% higher rate of achieving any ACR50 response within 12 months (59% vs. 44%).
• Modeled implementation of PrismRA resulted in cost savings across all financial variables, including a 4% decrease in total costs and significant reductions in spending on ineffective treatments.

Conclusions:

• Implementing the PrismRA test in routine clinical practice can potentially save over $7 million per 1000 patients in ineffective healthcare costs.
• Predictive testing with PrismRA can enhance targeted disease-modifying antirheumatic drug (DMARD) response rates in RA patients.