Many seniors with rheumatoid arthritis aren't receiving needed medications despite medical recommendations that patients receive early treatment, according to a new study led by a researcher from the Stanford University School of Medicine. Only 63% of Medicare-managed care patients diagnosed with the disease received any amount of the prescription drugs. The study was published in the Journal of the American Medical Association.
Which patients receive these medications also varies dramatically by their healthcare plan, their economic status, and where they live, the study found.
The medications, called disease-modifying antirheumatic drugs or DMARDs, range in cost from many thousands of dollars per year for some of the newer medications to a few hundred dollars for a year of treatment with some of the older drugs, researchers said.
"We counted patients who received the bare minimum amount of treatment, and still a large proportion of patients aren't getting the medication they need," said Gabriela Schmajuk, MD, lead author of the study.
"The reason treatment is so important is that if left untreated one-third of patients with rheumatoid arthritis will become disabled within five years of diagnosis," she said.
The study examined variations in medication treatment of 93,143 patients with rheumatoid arthritis who were at least 65 years old between 2005 and 2008. Information was obtained from the Centers for Medicare & Medicaid Services.
“We found that certain groups were not receiving the medication they needed,” Schmajuk said. “Patients who had low income received DMARDs less frequently than wealthier patients. Blacks received medications less frequently than whites. We also found that patients who lived in the mid- and south-Atlantic regions received medications less frequently than other areas, particularly the West Coast states.”
Researchers also found that treatment varied dramatically between healthcare plans. The database included about 300 different healthcare plans nationwide, although researchers didn't investigate the causes of the variations in treatment.