Coverage inequalities of new therapies for rheumatoid arthritis in a managed care setting.

Rheumatoid arthritis (RA) is a progressive disease that leads to functional disability and substantial medical costs. Early treatment with disease-modifying antirheumatic drugs (DMARDs) has been shown to inhibit the progression of RA, with accompanying improvements in functional outcome and long-term medical costs. Biologic response modifiers (BRMs) are a new class of therapeutic agents for RA that offer a more favorable side-effect profile than traditional DMARDs. One BRM, the self-injectable medication etanercept, has demonstrated great potential for improving the long-term prognosis of patients with RA. Unfortunately, patients' access to treatment with etanercept is sometimes limited because of the structure of health-care coverage for self-injectable drugs.