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There is a growing interest in the management of long-term conditions and increasing awareness of the need for compliance/adherence's assessment. An inexpensive and simple way to measure patients' treatment compliance is pharmacoeconomic measurement tools. The aim of the study is to increase the quality of assessment of patients' compliance through statistical methods in order to obtain a more accurate estimation and a shorter, easy-to-respond selfadministered questionnaire. We used the Compliance Questionnaire-Rheumatology (CQR) translated into Romanian and we verified the reliability and the internal consistency of this instrument. The research included 140 consecutive patients diagnosed with rheumatoid arthritis according to currently used criteria, with different treatment strategies and from different parts of Romania. Two methods for CQR's optimization were used. The first method identified associations between CQR score and patient compliance. An exploratory factor analysis was performed, as an alternative method, to reduce the number of items in CQR. The factor analysis identified a two-dimensional 9 item model that explains 66.78% of the variance in adherence and has a good internal consistency and fits the data. A shortened and optimized version of the CQR increases the clinical utility by reducing the patient's burden while maintaining a good level of reliability. [ABSTRACT FROM AUTHOR]

Rheumatoid arthritis represents the most common inflammatory rheumatism, affecting about 1% of the general population. Inappropriately untreated usually has a progressively aggressive perspective, generating pain and joint inflammation and functional disability. The severity of the disease results from the fact that more than 50% of patients cease their professional activity in the first 5 years of the disease and 10% of cases show severe disability in the first two years of evolution. The aim of the study is to conduct a comparative price analysis between a conventional remission therapy and a biological therapy for rheumatoid arthritis in Romania. Biologics are huge financial burden due to their high price, large number of patients and the considerable budget impact. The data was obtained from the official pages of National Health Insurance House in Romania up to date December 2018, and also the algorithm treatment for rheumatoid arthritis is followed. Conventional remission therapy is 30-100 times cheaper than biological therapy. The results show that two out of eight INNs (International non-proprietary name or a generic name) have authorized biosimilars (similar biological medicinal product) in Romania, despite of bigger number of authorized biosimilars in EMA (European Medicines Agency) for rheumatoid arthritis. Biosimilars' prices have a 19.66-29.68% reduction in the price of biologics. Introduction of biosimilars on the Romanian market will lead to significant decrease in reimbursed prices paid by public funds and thus increase the patients' access to biological therapy. [ABSTRACT FROM AUTHOR]

Patients adherence to treatment in rheumatoid arthritis case is less than optimal (patients do not take their medications half of the time) and the economic costs are emphasizing this problem. A non-adherent patient is costly and time-consuming. It was demonstrated that every dollar spent improving adherence saves seven dollars in total healthcare costs. The level of adherence can be improved if we can understand the correlation between patients behavior in taking their medication and the advices from doctors providing medical services. In order to assess the correct adherence, it is necessary to start using pharmacoeconomic instruments such as CQR-19, DAS, Morisky scale etc. These tools will guide the conversation and alert the physician or the pharmacist to discuss any potential issues during the patient's meeting. Patients who are involved in decisions about the medications they are prescribed are more likely to adhere their rheumatoid arthritis treatment plan. If medication costs are a barrier to adherence for the patients, they should use generic medicines. Other research wrote about the health impact of non-adherence and this analysis will emphasize the health-economics consequences of low adherence to medication-taking in rheumatoid arthritis. [ABSTRACT FROM AUTHOR]