Elaine Yung, Xiaoxuan Liu, Minal Aundhia, Chen Chen, Michael Wagner, Bin Huang, Hermine I Brunner
{"title":"Differences in time to drug initiation and inactive disease achievement by insurance type in patients with nonsystemic juvenile idiopathic arthritis.","authors":"Elaine Yung, Xiaoxuan Liu, Minal Aundhia, Chen Chen, Michael Wagner, Bin Huang, Hermine I Brunner","doi":"10.1007/s40267-026-01241-0","DOIUrl":"10.1007/s40267-026-01241-0","url":null,"abstract":"<p><strong>Introduction: </strong>Juvenile idiopathic arthritis (JIA) is a chronic autoimmune condition that can lead to significant complications if not promptly managed. Current guidelines recommend biologic or targeted synthetic disease modifying antirheumatic drugs (b/tsDMARDs) as part of the treatment algorithm. In the USA, patients are covered by a wide range of insurance plans that can be broadly classified into two categories-public or private. The influence of insurance type on access to JIA therapies and subsequent outcomes remains poorly understood. The objective of this study was to investigate how b/tsDMARD initiation and achievement of clinically inactive disease (CID) may differ by insurance type in patients with nonsystemic forms of JIA.</p><p><strong>Methods: </strong>Patients newly diagnosed with JIA according to International League of Associations (ILAR) for Rheumatology classification criteria between 2009 and 2020 at a large tertiary center were studied. Outcome variables of time to b/tsDMARD initiation and time to CID of JIA were assessed. Descriptive statistics were performed, and patients with public or private insurance were compared cross-sectionally and over the study timeframe using survival analysis.</p><p><strong>Results: </strong>There were 968 patients with newly diagnosed JIA during the study period; 753 (78%) were privately insured and 215 (22%) were publicly insured. During 5898 patient-years of follow-up, 562 (58%) patients initiated b/tsDMARDs and 677 (70%) patients achieved CID. Time to b/tsDMARD initiation did not differ by insurance type (both approximately 5 months, <i>p</i> = 0.51). Publicly insured patients had higher baseline disease activity and longer time to CID achievement compared with the privately insured (10 months versus 7 months, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>While time to b/tsDMARD initiation was similar across insurance groups, publicly insured patients achieved CID later than privately insured patients. These findings may be interpreted as insurance-associated differences. Additional studies are needed to clarify the roles of baseline disease severity, healthcare access, adherence, and socioeconomic context factors.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s40267-026-01241-0.</p>","PeriodicalId":36009,"journal":{"name":"Drugs and Therapy Perspectives","volume":"42 1","pages":"203-210"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13269468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Adeel Siddiqui, S. Shrestha, Ali Ahmed, Saba Mazhar, Omar Akhlaq Bhutta
{"title":"Addressing the opioid epidemic in Pakistan: urgent need for opioid stewardship and comprehensive solutions","authors":"Adeel Siddiqui, S. Shrestha, Ali Ahmed, Saba Mazhar, Omar Akhlaq Bhutta","doi":"10.1007/s40267-023-01021-0","DOIUrl":"https://doi.org/10.1007/s40267-023-01021-0","url":null,"abstract":"","PeriodicalId":36009,"journal":{"name":"Drugs and Therapy Perspectives","volume":"39 1","pages":"354 - 356"},"PeriodicalIF":1.2,"publicationDate":"2023-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46337257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Nails blue? Don’t be sad, the cause may be discoverable","authors":"Arnold Lee","doi":"10.1007/s40267-023-01022-z","DOIUrl":"https://doi.org/10.1007/s40267-023-01022-z","url":null,"abstract":"","PeriodicalId":36009,"journal":{"name":"Drugs and Therapy Perspectives","volume":"39 1","pages":"344 - 347"},"PeriodicalIF":1.2,"publicationDate":"2023-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41429960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Treat functional constipation in children with conventional options first and consider alternatives if needed","authors":"Tina Nie","doi":"10.1007/s40267-023-01020-1","DOIUrl":"https://doi.org/10.1007/s40267-023-01020-1","url":null,"abstract":"","PeriodicalId":36009,"journal":{"name":"Drugs and Therapy Perspectives","volume":"39 1","pages":"339 - 343"},"PeriodicalIF":1.2,"publicationDate":"2023-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43133294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Linzagolix in moderate to severe symptoms of uterine fibroids: a profile of its use","authors":"Simon Fung, Hannah A. Blair","doi":"10.1007/s40267-023-01019-8","DOIUrl":"https://doi.org/10.1007/s40267-023-01019-8","url":null,"abstract":"","PeriodicalId":36009,"journal":{"name":"Drugs and Therapy Perspectives","volume":"39 1","pages":"309 - 316"},"PeriodicalIF":1.2,"publicationDate":"2023-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41979091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Manage truncal acne and scarring the same as for facial acne, but more trunk-specific therapies are warranted","authors":"Connie Kang","doi":"10.1007/s40267-023-01018-9","DOIUrl":"https://doi.org/10.1007/s40267-023-01018-9","url":null,"abstract":"","PeriodicalId":36009,"journal":{"name":"Drugs and Therapy Perspectives","volume":"39 1","pages":"324 - 329"},"PeriodicalIF":1.2,"publicationDate":"2023-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46489089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Adis Summary of Research: Safety, Effectiveness, and Immunogenicity 6 Months After BNT162B2 mRNA Vaccine in Frail Nursing Home Residents","authors":"J. Paik, Zaina T. Al-Salama","doi":"10.1007/s40267-023-01010-3","DOIUrl":"https://doi.org/10.1007/s40267-023-01010-3","url":null,"abstract":"","PeriodicalId":36009,"journal":{"name":"Drugs and Therapy Perspectives","volume":"39 1","pages":"317 - 318"},"PeriodicalIF":1.2,"publicationDate":"2023-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49093780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Consider comorbidities, concomitant medications and organ function when treating chronic urticaria in older adults","authors":"Tina Nie","doi":"10.1007/s40267-023-01016-x","DOIUrl":"https://doi.org/10.1007/s40267-023-01016-x","url":null,"abstract":"","PeriodicalId":36009,"journal":{"name":"Drugs and Therapy Perspectives","volume":"39 1","pages":"319 - 323"},"PeriodicalIF":1.2,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47956069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Tapinarof cream 1% in plaque psoriasis: a profile of its use","authors":"M. Shirley","doi":"10.1007/s40267-023-01014-z","DOIUrl":"https://doi.org/10.1007/s40267-023-01014-z","url":null,"abstract":"","PeriodicalId":36009,"journal":{"name":"Drugs and Therapy Perspectives","volume":"39 1","pages":"303 - 308"},"PeriodicalIF":1.2,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46798960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}