Patients in Support Programs for Painful Autoimmune Conditions May Have Reduced Opioid Use

Programs that provide ongoing support to patients with painful conditions and complex medication regimens may also help them avoid using opioid pain medications or reduce the amount that they use, according to a study published in Rheumatology and Therapy.

The study examined patients with a range of autoimmune disorders, including arthritis and psoriasis, who were taking an injected biologic medication to treat their symptoms and prevent painful flare-ups. This type of treatment requires frequent self-injections on a strict schedule, special disposal of used supplies, and typically high out-of-pocket costs. This has led to the formation of patient support programs (PSPs) by drug companies, intended to keep patients on track and potentially reduce their costs.

The researchers utilized anonymous data from patients with autoimmune disorder with private insurance, examining treatment adherence and opioid prescription fills for nearly 2000 new biologic patients who took part in a PSP at least for a short time, and 728 who did not. None of the participants had received an opioid in the 3 months prior to starting on the biologic, and most of those participating in the study were women over the age of 50 years.

According to the authors of the study, patients in a PSP were 13% less likely to start taking opioid pain medications, 26% less likely to fill 2 or more opioid prescriptions, and were far more likely to adhere to their medication regimen. However, 38% of the patients in the support program filled at least 1 opioid prescription, and 19% filled 2 or more.

Among all patients who filled at least 1 opioid prescription, those participating in a PSP were less likely to use them for an extended time. These differences remained significant after accounting for differences in income and past cancer diagnosis— cancer-related pain is a CDC-recommended use for opioid pain medication, while autoimmune disorders are not. The study also found that the strongest evidence of a difference between PSP participants and nonparticipants was in the group taking a biologic for a digestive system autoimmune disorder such as ulcerative colitis or Crohn disease.

“This research demonstrates that the addition of a multi-faceted patient support program along with specialty medication led to better patient-centered outcomes when compared to the use of medication alone,” said Mark Fendrick, MD, professor of internal medicine at the University of Michigan and director of the Center for Value Based Insurance Design, in a press release. “As more and more Americans are prescribed complicated medication regimens, the availability of additional resources is likely to lead to higher rates of medication adherence, and healthier, more satisfied patients.”

REFERENCE

Patient support program for painful conditions may reduce opioid use [news release]. EurekAlert; May 6, 2021. Accessed May 14, 2021. https://www.eurekalert.org/pub_releases/2021-05/mm-u-psp050621.php