Etanercept for RA On-the-Job: A Boon for the Budget

Etanercept (Enbrel) patients who continue taking the drug while going to work are still productive and take less time off than those who stop taking the drug. This may help to offset the high cost of the drug, finds a manufacturer-supported study.

Hone D, Cheng A, Watson C, et al. Impact of Etanercept on Work and Activity Impairment in Employed Moderate to Severe Rheumatoid Arthritis Patients in the United States. Arthritis Care & Research (2013) doi:10.1002/acr.22022. First published online September 24, 2013 (open access).

For employed people with moderate to severe rheumatoid arthritis (RA), a study finds that greater on-the-job productivity and reduced impairment may partly or completely offset the expense of the drug etanercept (Enbrel).

The multi-center study of 204 RA etanercept-treated patients shows that those who continue treatment for 6 months (n=153) have less impairment, absenteeism, and higher work productivity compared with those who stop the medication (n=51).

The cohort consisted of 72% women (mean age 46.6) with the majority working full-time at a managerial or professional job for around 10 years. They report losing almost 25 hours of work a year (3.8 hours a week) due to their RA symptoms at study inception.

However, those continuing etanercept for 6 months report fewer lost hours of work per week (1.7), less absenteeism (4.1%), almost 14% improvement in work impairment, nearly 16% in productivity gains, and a 24.7% improvement in overall activity.

The average economic gain from such on-the-job improvements, $3,233 to $22,532, partially or totally offset the $20,000 annual cost of etanercept (at the 2009 price), especially for those at higher income levels.

The etanercept group also reports an improvement in domestic activity and satisfaction, according to their responses to the RA-specific Work Productivity and Activity Impairment (WPAI) questionnaire.

In contrast, those who discontinue therapy say they lost more time from work, had more absenteeism, and greater work impairment.

The most common reasons for stopping etanercept include lack of effectiveness (77.5%) and financial constraints (22.5%).

Study funding was provided by Immunex, a wholly owned subsidiary of Amgen, manufacturer of Enbrel). The study authors report financial relationships with Amgen. One co-author is an employee of Amgen.