2010 Grant Awards

The posters and papers listed below each grant arise from work facilitated through the grant funding.

From Prediction to Proof: Using Linked Data to Observe Reductions in RA Costs Following Expansion of Biologic Therapies

Principal Investigator: Anis, A (PDF)
Co-investigators: Lacaille, D; Bansback, N

Project Summary

Our research has identified that the types health care resources consumed by patients with RA has changed dramatically over the past 10 years. Importantly, rates of hospitalizations were decreasing before the introduction of biologics. This leads to question whether the subsequent reductions in hospitalizations and other non-drug utilization were related to the introduction of biologics, or whether we would have seen these reductions anyway.

  • To address this question, we used an instrumental variable (IV) analysis based on perceived heterogeneity in rheumatologists’ preference for biologic use in eligible patients between 2004 and 2006. This enables causal estimates on the effect of biologics on resource utilization by considering unobserved confounding variables which are not usually addressed (such as disease severity). Identifying IVs that work in administrative data are difficult, and this achievement will lead to other projects where we would like to ascertain the influence of biologic treatments.
  • The main finding of our work is that in comparison to DMARD users, biologic users consumed 30% more in total RA related expenditures and 13% more in total expenditures excluding DMARD and biologics treatment over the 4 years. This result is counter to our original hypothesis, but supported by a number a sensitivity analyses. Current assumptions that biologics save costs are therefore not supported by evidence.

Poster Presentations

Presented at the 2012 European League Against Rheumatism (EULAR) meeting.

Presented at the 2013 Canadian Rheumatology Association meeting.