Cost, prior authorization influences physicians’ treatment preferences for ocular Behçet disease
Rheumatologists and ophthalmologists’ preferences regarding treatment options for ocular Behçet disease are impacted by concerns about cost and prior authorization, according to a study.
Of 852 rheumatologists and 934 ophthalmologists who were contacted via email to complete a survey regarding choice of treatment for a patient with ocular Behçet disease, 68 rheumatologists and 64 ophthalmologists completed the survey.
Results showed 28% of rheumatologists and 11% of ophthalmologists selected methotrexate, 12% of rheumatologists and 20% of ophthalmologists selected mycophenolate mofetil and 22% of rheumatologists and 3% of ophthalmologists selected azathioprine as first-choice therapy before adjusting for cost and prior authorization. After adjusting for cost and prior authorization, 13% of rheumatologists and 3% of ophthalmologists selected methotrexate; 3% of rheumatologists and 11% of ophthalmologists selected mycophenolate mofetil; and 16% of rheumatologists and 3% of ophthalmologists selected azathioprine as first-choice therapy.
In addition, after adjusting for cost and prior authorization, the number of physicians who selected a biologic agent as first-choice therapy significantly increased (31% vs. 65% of rheumatologists; 38% vs. 63% of ophthalmologists), and the number of physicians who selected an anti-tumor necrosis factor as first-choice therapy slightly decreased (81% vs. 79% of rheumatologists; 94% vs. 93% of ophthalmologists).
While study results show the differences in first-choice therapies for patients with ocular Behçet disease between rheumatologists and ophthalmologists before and after adjusting for cost and prior authorization, researchers wrote, “In absence of [randomized controlled trials] RCTs and studies of comparative effectiveness, physicians must rely on their experience training and interpretation of less robust forms of data in the published literature.” – by Nhu Te
Disclosure: The researchers report no relevant financial disclosures.
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