Trial Outcomes & Findings for A Study to Evaluate Patient Characteristics and Treatment Patterns Among Rheumatoid Arthritis Patients (NCT NCT04047121)

NCT ID: NCT04047121

Last Updated: 2023-06-09

Results Overview

Persistent with the index medication was defined as not having a gap in the therapy of at least 60 days between prescription fill dates and their administration. Index medications were tofacitinib, adalimumab or etanercept.

• Recruitment status: COMPLETED
• Target enrollment: 1349 participants
• Primary outcome timeframe: During 12 months post-index date
• Results posted on: 2023-06-09

Participant Flow

5-years data were retrieved from insurance claims Truven Health MarketScan Research Databases and were evaluated in 5 months of this retrospective, observational study. Participants who initiated treatment with tofacitinib, adalimumab or etanercept for rheumatoid arthritis (RA), between January 2014 and September 2016 were involved in this study.

5-years (January 2012 to September 2017) included pre-index of 2 years, 2 years to capture treatment initiation (index date), and 1 year for follow-up post-index. Index date was first prescription date of treatment (tofacitinib, adalimumab or etanercept) from January 2014 to September 2016.

Participant milestones

Measure	Tofacitinib Low Out of Pocket (OOP) Cost Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Overall Study STARTED	310	299	79	287	112	262
Overall Study COMPLETED	310	299	79	287	112	262
Overall Study NOT COMPLETED	0	0	0	0	0	0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Race and Ethnicity were not collected from any participant.

Baseline characteristics by cohort

Measure	Tofacitinib Low OOP Cost n=310 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=299 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=79 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=287 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=112 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=262 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.	Total n=1349 Participants Total of all reporting groups
Age, Continuous	58.67 Years STANDARD_DEVIATION 12.93 • n=310 Participants	54.44 Years STANDARD_DEVIATION 11.01 • n=299 Participants	50.52 Years STANDARD_DEVIATION 11.60 • n=79 Participants	55.15 Years STANDARD_DEVIATION 11.14 • n=287 Participants	53.36 Years STANDARD_DEVIATION 12.05 • n=112 Participants	54.50 Years STANDARD_DEVIATION 12.25 • n=262 Participants	55.26 Years STANDARD_DEVIATION 12.03 • n=1349 Participants
Sex: Female, Male Female	248 Participants n=310 Participants	240 Participants n=299 Participants	62 Participants n=79 Participants	243 Participants n=287 Participants	85 Participants n=112 Participants	219 Participants n=262 Participants	1097 Participants n=1349 Participants
Sex: Female, Male Male	62 Participants n=310 Participants	59 Participants n=299 Participants	17 Participants n=79 Participants	44 Participants n=287 Participants	27 Participants n=112 Participants	43 Participants n=262 Participants	252 Participants n=1349 Participants
Race and Ethnicity Not Collected	—	—	—	—	—	—	0 Participants Race and Ethnicity were not collected from any participant.
Geographic Region Northeast Region	97 Participants n=310 Participants	61 Participants n=299 Participants	12 Participants n=79 Participants	58 Participants n=287 Participants	17 Participants n=112 Participants	57 Participants n=262 Participants	302 Participants n=1349 Participants
Geographic Region North Central Region	68 Participants n=310 Participants	61 Participants n=299 Participants	16 Participants n=79 Participants	55 Participants n=287 Participants	30 Participants n=112 Participants	43 Participants n=262 Participants	273 Participants n=1349 Participants
Geographic Region South Region	108 Participants n=310 Participants	135 Participants n=299 Participants	41 Participants n=79 Participants	137 Participants n=287 Participants	41 Participants n=112 Participants	128 Participants n=262 Participants	590 Participants n=1349 Participants
Geographic Region West Region	37 Participants n=310 Participants	42 Participants n=299 Participants	10 Participants n=79 Participants	34 Participants n=287 Participants	24 Participants n=112 Participants	34 Participants n=262 Participants	181 Participants n=1349 Participants
Geographic Region Unknown Region	0 Participants n=310 Participants	0 Participants n=299 Participants	0 Participants n=79 Participants	3 Participants n=287 Participants	0 Participants n=112 Participants	0 Participants n=262 Participants	3 Participants n=1349 Participants
Pre-index Biologic Disease Modifying Antirheumatic Drugs (bDMARDs) Use	0 Participants n=310 Participants	0 Participants n=299 Participants	52 Participants n=79 Participants	238 Participants n=287 Participants	87 Participants n=112 Participants	224 Participants n=262 Participants	601 Participants n=1349 Participants
Pre-index Non-biological Disease Modifying Antirheumatic Drug (NB-DMARDs) Use	245 Participants n=310 Participants	243 Participants n=299 Participants	64 Participants n=79 Participants	226 Participants n=287 Participants	79 Participants n=112 Participants	198 Participants n=262 Participants	1055 Participants n=1349 Participants
Disease Duration	511.92 Days STANDARD_DEVIATION 310.83 • n=310 Participants	563.50 Days STANDARD_DEVIATION 317.53 • n=299 Participants	452.04 Days STANDARD_DEVIATION 254.00 • n=79 Participants	685.60 Days STANDARD_DEVIATION 313.28 • n=287 Participants	432.03 Days STANDARD_DEVIATION 216.31 • n=112 Participants	640.35 Days STANDARD_DEVIATION 278.94 • n=262 Participants	575.11 Days STANDARD_DEVIATION 308.02 • n=1349 Participants
Pre-index Claims-based Index For Rheumatoid Arthritis Severity (CIRAS)	4.50 Units on a scale STANDARD_DEVIATION 1.62 • n=310 Participants	4.94 Units on a scale STANDARD_DEVIATION 1.48 • n=299 Participants	5.15 Units on a scale STANDARD_DEVIATION 1.51 • n=79 Participants	4.71 Units on a scale STANDARD_DEVIATION 1.44 • n=287 Participants	4.61 Units on a scale STANDARD_DEVIATION 1.29 • n=112 Participants	4.65 Units on a scale STANDARD_DEVIATION 1.47 • n=262 Participants	4.72 Units on a scale STANDARD_DEVIATION 1.50 • n=1349 Participants
Quan-Charlson Score 0	1 Participants n=310 Participants	0 Participants n=299 Participants	0 Participants n=79 Participants	0 Participants n=287 Participants	2 Participants n=112 Participants	1 Participants n=262 Participants	4 Participants n=1349 Participants
Quan-Charlson Score 1-2	235 Participants n=310 Participants	244 Participants n=299 Participants	65 Participants n=79 Participants	226 Participants n=287 Participants	91 Participants n=112 Participants	208 Participants n=262 Participants	1069 Participants n=1349 Participants
Quan-Charlson Score 3-4	52 Participants n=310 Participants	46 Participants n=299 Participants	10 Participants n=79 Participants	52 Participants n=287 Participants	15 Participants n=112 Participants	37 Participants n=262 Participants	212 Participants n=1349 Participants
Quan-Charlson Score Greater than or equal to (>=) 5	22 Participants n=310 Participants	9 Participants n=299 Participants	4 Participants n=79 Participants	9 Participants n=287 Participants	4 Participants n=112 Participants	16 Participants n=262 Participants	64 Participants n=1349 Participants

PRIMARY outcome

Timeframe: During 12 months post-index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation.

Persistent with the index medication was defined as not having a gap in the therapy of at least 60 days between prescription fill dates and their administration. Index medications were tofacitinib, adalimumab or etanercept.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=310 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=299 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=79 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=287 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=112 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=262 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Percentage of Participants Who Were Persistent With Index Medication During 12 Months Post-index Date	47.42 Percentage of participants	42.81 Percentage of participants	36.71 Percentage of participants	50.52 Percentage of participants	38.39 Percentage of participants	45.80 Percentage of participants

PRIMARY outcome

Timeframe: During 12 months post-index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation.

Participants who switched from index medication immediately were those who initiated a non-index advanced therapy before end of a 60-day gap in index medication. Index medications were tofacitinib, adalimumab or etanercept.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=310 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=299 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=79 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=287 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=112 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=262 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Percentage of Participants Who Immediately Switched Index Medication During 12 Months Post-index Date	10.32 Percentage of participants	10.70 Percentage of participants	22.78 Percentage of participants	15.33 Percentage of participants	25.89 Percentage of participants	22.90 Percentage of participants

PRIMARY outcome

Timeframe: During 12 months post-index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation.

Participants who discontinued index medication then switched from index medication were those who had gap in the index medication therapy of at least 60 days and then after the gap they switched to an advanced therapy different from index medication. Index medications were tofacitinib, adalimumab or etanercept.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=310 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=299 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=79 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=287 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=112 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=262 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Percentage of Participants Who Discontinued Then Switched Index Medication During 12 Months Post-index Date	3.87 Percentage of participants	4.68 Percentage of participants	8.86 Percentage of participants	6.62 Percentage of participants	7.14 Percentage of participants	5.34 Percentage of participants

PRIMARY outcome

Timeframe: During 12 months post index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation.

Participants who discontinued index medication and then restarted index medication were those who had a gap in the index medication therapy of at least 60 days and the first advanced therapy observed after the gap was the index medication. Index medications were tofacitinib, adalimumab or etanercept.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=310 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=299 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=79 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=287 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=112 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=262 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Percentage of Participants Who Discontinued Then Restarted Index Medication During 12 Months Post-index Date	13.23 Percentage of participants	15.72 Percentage of participants	11.39 Percentage of participants	10.10 Percentage of participants	11.61 Percentage of participants	10.69 Percentage of participants

PRIMARY outcome

Timeframe: During 12 months post index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation.

Participants who discontinued index medication without switching or restarting index medication were those who had a gap in index medication therapy of at least 60 days and there were no claims for either the index medication or a different advanced therapy for the remainder of the follow-up period. Index medications were tofacitinib, adalimumab or etanercept.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=310 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=299 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=79 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=287 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=112 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=262 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Percentage of Participants Who Discontinued Without Switching or Restarting Index Medication During 12 Months Post-index Date	25.16 Percentage of participants	26.09 Percentage of participants	20.25 Percentage of participants	17.42 Percentage of participants	16.96 Percentage of participants	15.27 Percentage of participants

SECONDARY outcome

Timeframe: During 12 months post-index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation.

Participants who switched from index medication at any time during the 12-month follow-up post-index period were evaluated. Index medications were tofacitinib, adalimumab or etanercept.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=310 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=299 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=79 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=287 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=112 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=262 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Percentage of Participants Who Switched Index Medication Any Time During 12 Months Post-index Date	14.19 Percentage of participants	16.05 Percentage of participants	34.18 Percentage of participants	23.00 Percentage of participants	35.71 Percentage of participants	29.77 Percentage of participants

SECONDARY outcome

Timeframe: During 12 months post-index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation. Here, "Overall Number of Participants Analyzed" refers to participants evaluable for this outcome measure.

Participants who switched from index medication immediately were those who initiated a non-index advanced therapy before the end of a 60-day gap in index medication. Index medications were tofacitinib, adalimumab or etanercept. Number of days to immediately switch from index medication = immediate switch date - index date + 1.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=32 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=32 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=18 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=44 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=29 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=60 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Mean of Number of Days to Immediate Switch From Index Medication During 12 Months Post-index Date	155.00 Days Standard Deviation 91.02	149.56 Days Standard Deviation 88.40	144.00 Days Standard Deviation 59.64	125.84 Days Standard Deviation 84.73	148.69 Days Standard Deviation 73.22	145.37 Days Standard Deviation 87.59

SECONDARY outcome

Timeframe: During 12 month post-index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation. Here, "Overall Number of Participants Analyzed" refers to participants evaluable for this outcome measure.

Number of days to immediate or delayed switch from index medication any time during the 12-month follow-up period = immediate or delayed switch date - index date + 1. Index medications were tofacitinib, adalimumab or etanercept.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=44 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=48 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=27 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=66 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=40 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=78 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Mean of Number of Days to Immediate or Delayed Switch Index Medication During 12 Months Post-index Date	168.11 Days Standard Deviation 84.29	175.98 Days Standard Deviation 90.52	182.70 Days Standard Deviation 83.90	158.71 Days Standard Deviation 90.81	170.73 Days Standard Deviation 81.64	169.36 Days Standard Deviation 96.58

SECONDARY outcome

Timeframe: During 12 months post-index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation. Here, "Overall Number of Participants Analyzed" refers to participants evaluable for this outcome measure.

Number of days to discontinue index medication = date of last persistent index medication prescription/administration + days supply- index date + 1. Index medications were tofacitinib, adalimumab or etanercept. Persistent with the index medication was defined as not having a gap in the therapy of at least 60 days between prescription fill dates and their administration.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=158 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=168 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=50 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=139 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=68 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=138 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Mean of Number of Days to Discontinue Index Medication During 12 Months Post-index Date	119.62 Days Standard Deviation 80.01	106.17 Days Standard Deviation 76.50	111.74 Days Standard Deviation 74.97	109.42 Days Standard Deviation 74.16	130.18 Days Standard Deviation 70.71	118.91 Days Standard Deviation 77.58

SECONDARY outcome

Timeframe: During 12 months post-index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation.

Index medication persistent therapy duration was defined as days to discontinue or immediate switch or end of 12 months post-index follow if participants remained persistent, whichever came first. Index medications were tofacitinib, adalimumab or etanercept. Persistent with the index medication: not having a gap in the therapy of at least 60 days between prescription fill dates and their administration. Discontinuation from index medication: gap in the index medication therapy of at least 60 days. Immediate switch from index medication: initiation of a non-index advanced therapy before end of a 60-day gap in index medication.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=310 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=299 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=79 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=287 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=112 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=262 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Duration of Index Medication Persistent Therapy During 12 Months Post-index Date	235.60 Days Standard Deviation 133.02	273.50 Days Standard Deviation 136.81	203.65 Days Standard Deviation 133.21	239.02 Days Standard Deviation 134.51	219.75 Days Standard Deviation 126.09	234.34 Days Standard Deviation 131.10

SECONDARY outcome

Timeframe: During 12 months post-index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation. Here, "Overall Number of Participants Analyzed" refers to participants evaluable for this outcome measure.

Participants who initiated index medication in combination with main NB-DMARDSs were analyzed to evaluate percentage of participants who were persistent with main NB-DMARDs use. Main NB-DMARDs considered in the study were methotrexate, sulfasalazine, leflunomide, and hydroxychloroquine. Index medications were tofacitinib, adalimumab or etanercept. Persistence with main NB-DMARDs was defined as not having a gap of at least 60 days between prescription fill dates and their administration.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=157 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=145 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=44 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=151 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=57 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=105 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Percentage of Participants Who Were Persistent With Main Non-Biologic Disease Modifying Antirheumatic Drugs (NB-DMARD) During 12 Months Post-index Date: Combination Therapy	36.31 Percentage of participants	35.86 Percentage of participants	36.36 Percentage of participants	43.71 Percentage of participants	38.60 Percentage of participants	42.86 Percentage of participants

SECONDARY outcome

Timeframe: During 12 months post-index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation. Here, "Overall Number of Participants Analyzed" refers to participants evaluable for this outcome measure.

Participants who initiated index medication in combination with main NB-DMARDSs were analyzed to evaluate percentage of participants who immediately switched from main NB-DMARDs. Main NB-DMARDS considered in the study were methotrexate, sulfasalazine, leflunomide, and hydroxychloroquine. Index medications were tofacitinib, adalimumab or etanercept. Immediate switch from main NB-DMARDs was defined as initiation of other medication than main NB-DMARDs, before end of a 60-day gap.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=157 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=145 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=44 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=151 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=57 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=105 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Percentage of Participants Who Immediately Switched From Main NB-DMARDs During 12 Months Post-index Date: Combination Therapy	30.57 Percentage of participants	26.21 Percentage of participants	22.73 Percentage of participants	22.52 Percentage of participants	31.58 Percentage of participants	23.81 Percentage of participants

SECONDARY outcome

Timeframe: During 12 months post-index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation. Here, "Overall Number of Participants Analyzed" refers to participants evaluable for this outcome measure.

Participants who initiated index medication in combination with main NB-DMARDSs were analyzed to evaluate percentage of participants who discontinued then switched from main NB-DMARDs. Main NB-DMARDS considered in the study were methotrexate, sulfasalazine, leflunomide, and hydroxychloroquine. Index medications were tofacitinib, adalimumab or etanercept. Participants who discontinued main NB-DMARDs then switched from main NB-DMARDS were those who had gap in the main NB-DMARDs medication of at least 60 days and then after the gap switched to other medication than main NB-DMARDs.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=157 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=145 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=44 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=151 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=57 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=105 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Percentage of Participants Who Discontinued Then Switched From Main NB-DMARDs During 12 Months Post-index Date: Combination Therapy	2.55 Percentage of participants	0.69 Percentage of participants	6.82 Percentage of participants	2.65 Percentage of participants	0.00 Percentage of participants	0.00 Percentage of participants

SECONDARY outcome

Timeframe: During 12 months post-index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation. Here, "Overall Number of Participants Analyzed" refers to participants evaluable for this outcome measure.

Participants who initiated index medication in combination with main NB-DMARDSs were analyzed to evaluate percentage of participants who discontinued then restarted main NB-DMARDs. Main NB-DMARDS considered in the study were methotrexate, sulfasalazine, leflunomide, and hydroxychloroquine. Index medications were tofacitinib, adalimumab or etanercept. Participants who discontinued main NB-DMARDs and then restarted main NB-DMARDs were those who had a gap in main NB-DMARDs of at least 60 days and after the gap, they started main NB-DMARDs again.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=157 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=145 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=44 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=151 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=57 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=105 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Percentage of Participants Who Discontinued Then Restarted Main NB-DMARDs During 12 Months Post-index Date: Combination Therapy	13.38 Percentage of participants	12.41 Percentage of participants	13.64 Percentage of participants	11.26 Percentage of participants	21.05 Percentage of participants	18.10 Percentage of participants

SECONDARY outcome

Timeframe: During 12 months post-index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation. Here, "Overall Number of Participants Analyzed" refers to participants evaluable for this outcome measure.

Participants who initiated index medication in combination with main NB-DMARDSs were analyzed to evaluate percentage of participants who discontinued without switching or restarting main NB-DMARDs. Main NB-DMARDS considered in the study were methotrexate, sulfasalazine, leflunomide, and hydroxychloroquine. Index medications were tofacitinib, adalimumab or etanercept. Participants who discontinued main NB-DMARDs without switching or restarting main NB-DMARDs were those who had a gap in main NB-DMARDs of at least 60 days and there were no claims for either the main NB-DMARDs or a different therapy for the remainder of the follow-up period.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=157 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=145 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=44 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=151 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=57 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=105 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Percentage of Participants Who Discontinued Without Switching or Restarting Main NB-DMARDs During 12 Months Post-index Date: Combination Therapy	17.20 Percentage of participants	24.83 Percentage of participants	20.45 Percentage of participants	19.87 Percentage of participants	8.77 Percentage of participants	15.24 Percentage of participants

SECONDARY outcome

Timeframe: During 12 months post-index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation.

Percentage of participants who initiated only index medication and then eventually also added any NB-DMARDs, 1 of the 4 mains NB-DMARDs or other than these 4 NB-DMARDs in their therapy, were evaluated. Main NB-DMARDS considered in the study were methotrexate, sulfasalazine, leflunomide, and hydroxychloroquine. Any NB-DMARDs included those participants who received any of the NB-DMARDs and participant was counted only once if took different NB-DMARDs during the follow-up period. Participants might be counted more than once in categories except category "Any NB-DMARDs". Index medications were tofacitinib, adalimumab or etanercept.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=310 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=299 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=79 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=287 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=112 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=262 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Percentage of Participants Who Initiated Index Medication as Monotherapy and Eventually Added NB-DMARDs During 12 Months Post-index Date Sulfasalazine	1.96 Percentage of participants	2.60 Percentage of participants	8.57 Percentage of participants	2.21 Percentage of participants	5.45 Percentage of participants	1.91 Percentage of participants
Percentage of Participants Who Initiated Index Medication as Monotherapy and Eventually Added NB-DMARDs During 12 Months Post-index Date Hydroxychloroquine	8.50 Percentage of participants	9.09 Percentage of participants	20.00 Percentage of participants	3.68 Percentage of participants	5.45 Percentage of participants	5.10 Percentage of participants
Percentage of Participants Who Initiated Index Medication as Monotherapy and Eventually Added NB-DMARDs During 12 Months Post-index Date Other NB-DMARD	3.27 Percentage of participants	3.90 Percentage of participants	2.86 Percentage of participants	1.47 Percentage of participants	0.00 Percentage of participants	4.46 Percentage of participants
Percentage of Participants Who Initiated Index Medication as Monotherapy and Eventually Added NB-DMARDs During 12 Months Post-index Date Any NB-DMARD	29.41 Percentage of participants	28.57 Percentage of participants	48.57 Percentage of participants	25.74 Percentage of participants	34.55 Percentage of participants	26.75 Percentage of participants
Percentage of Participants Who Initiated Index Medication as Monotherapy and Eventually Added NB-DMARDs During 12 Months Post-index Date Methotrexate	16.99 Percentage of participants	11.69 Percentage of participants	22.86 Percentage of participants	14.71 Percentage of participants	27.27 Percentage of participants	12.74 Percentage of participants
Percentage of Participants Who Initiated Index Medication as Monotherapy and Eventually Added NB-DMARDs During 12 Months Post-index Date Leflunomide	3.92 Percentage of participants	5.19 Percentage of participants	17.14 Percentage of participants	5.15 Percentage of participants	3.64 Percentage of participants	6.37 Percentage of participants

SECONDARY outcome

Timeframe: During 12 months post-index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation.

A proportion of days covered (PDC) was calculated based on total days' supply over the 12 months post-index. The PDC was calculated by using the date of service and the day supply for each fill of the index medication. Participants with early refills were allowed to stockpile medications up to a maximum of 14 days total for later use. Participants who met adherence effective criteria were those who had PDC >=0.8. Index medications were tofacitinib, adalimumab or etanercept.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=310 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=299 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=79 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=287 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=112 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=262 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Percentage of Participants Who Met Adherence Effectiveness Criteria During 12 Months Post-index Date	38.71 Percentage of participants	36.12 Percentage of participants	30.38 Percentage of participants	44.95 Percentage of participants	33.04 Percentage of participants	38.93 Percentage of participants

SECONDARY outcome

Timeframe: During 12 months post-index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation.

Dose escalation for index medication was defined as: 1) for adalimumab: at least 1 claim in the 12 months post-index follow-up with an average weekly dose of at least 40 milligram per week (mg/week), 2) for etanercept: at least 1 claim in the 12 months post-index follow-up with an average weekly dose of at least 100 mg/week, 3) for tofacitinib: at least 1 claim in the 12 months post-index follow-up with an average weekly dose of at least 20 milligram per day (mg/day) for immediate release and 22 mg/day for extended release. Participants who met dose escalation effectiveness criteria were those who did not have any dose escalation for index medication compared to the starting dose.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=310 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=299 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=79 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=287 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=112 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=262 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Percentage of Participants Who Met Dose Escalation Effectiveness Criteria During 12 Months Post-index Date	96.13 Percentage of participants	94.31 Percentage of participants	97.47 Percentage of participants	94.77 Percentage of participants	81.25 Percentage of participants	95.80 Percentage of participants

SECONDARY outcome

Timeframe: During 12 months post-index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation.

A switch for this outcome measure was defined as use of a different biologic disease modifying antirheumatic drug (B-DMARDs) or Janus kinase inhibitor (JAKi), any time during the 12 months post-index follow-up. Participants who met switched effectiveness criteria were those who did not switch from the index medication to B-DMARDs or JAKi. Index medications were tofacitinib, adalimumab or etanercept.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=310 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=299 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=79 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=287 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=112 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=262 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Percentage of Participants Who Met Switched Effectiveness Criteria During 12 Months Post-index Date	85.81 Percentage of participants	83.95 Percentage of participants	65.82 Percentage of participants	77.00 Percentage of participants	64.29 Percentage of participants	70.23 Percentage of participants

SECONDARY outcome

Timeframe: During 12 months post-index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation.

Participants who started only index medication regimen (as monotherapy), but eventually initiated main NB-DMARDs were identified in the 12 months post-index follow-up period as adding new NB-DMARD. Participants who started index medication regimen along with any of the main NB-DMARDs (combination therapy), presence of a different NB-DMARD in 12 months post-index was identified as adding new NB-DMARD. Participants who met NB-DMARD effectiveness criteria were those who did not add a new NB-DMARD in the 12 months post-index follow up. Index medications were tofacitinib, adalimumab or etanercept.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=310 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=299 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=79 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=287 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=112 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=262 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Percentage of Participants Who Met NB-DMARD Effectiveness Criteria During 12 Months Post-index Date	71.61 Percentage of participants	74.58 Percentage of participants	64.56 Percentage of participants	77.00 Percentage of participants	66.96 Percentage of participants	79.39 Percentage of participants

SECONDARY outcome

Timeframe: During 12 months post-index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation.

Oral glucocorticoid effectiveness criteria for participants with no claims for oral glucocorticoid prescriptions in the 6 months prior to the index date = did not receive more than 30 days of oral glucocorticoids between (index date + 89 days) to (index date + 359 days). 30 days of oral glucocorticoids was determined by summing up the day supply of all glucocorticoids claims with a fill date between (index date + 89 days) to (index date + 359 days). Oral glucocorticoid effectiveness criteria for participants with claims for oral glucocorticoids during the 6 months prior to the index date = no increase in oral glucocorticoid dose >=20% during months 6-12 after index compared to the 6 months before the index date. Increase in oral glucocorticoids was determined from the prednisone equivalent dose for all glucocorticoid claims filled.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=310 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=299 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=79 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=287 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=112 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=262 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Percentage of Participants Who Met Oral Glucocorticoid Effectiveness Criteria During 12 Months Post-index Date	83.55 Percentage of participants	86.96 Percentage of participants	83.54 Percentage of participants	85.02 Percentage of participants	86.61 Percentage of participants	81.30 Percentage of participants

SECONDARY outcome

Timeframe: During 12 months post-index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation

Glucocorticoid infusion effectiveness criteria was receiving of maximum of 1 parenteral or intra-articular glucocorticoid joint injection on unique days (between [index date + 89 days] to [index date + 359 days]) after the participants had been on treatment with index medication for more than 3 months. Index medications were tofacitinib, adalimumab or etanercept.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=310 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=299 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=79 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=287 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=112 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=262 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Percentage of Participants Who Met Infusion Glucocorticoid Effectiveness Criteria During 12 Months Post-index Date	83.87 Percentage of participants	82.61 Percentage of participants	74.68 Percentage of participants	82.58 Percentage of participants	83.04 Percentage of participants	76.34 Percentage of participants

SECONDARY outcome

Timeframe: During 12 months pre-index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation.

Inpatient visits refers when participants visited hospital for formal admission. In this outcome measure, mean of number of inpatient visits related to RA during 12 months pre-index were evaluated.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=310 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=299 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=79 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=287 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=112 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=262 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Mean of Rheumatoid Arthritis (RA) Related Inpatient Visits During 12 Months Pre-index Date	0.08 Inpatient visits Standard Deviation 0.28	0.09 Inpatient visits Standard Deviation 0.38	0.05 Inpatient visits Standard Deviation 0.22	0.08 Inpatient visits Standard Deviation 0.31	0.04 Inpatient visits Standard Deviation 0.25	0.08 Inpatient visits Standard Deviation 0.32

SECONDARY outcome

Timeframe: During 12 months pre-index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation.

In this outcome measure, mean of number of emergency department visits related to RA during 12 months pre-index were evaluated.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=310 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=299 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=79 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=287 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=112 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=262 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Mean of Rheumatoid Arthritis Related Emergency Department (ED) Visits During 12 Months Pre-Index Date	0.16 Emergency department visits Standard Deviation 0.53	0.10 Emergency department visits Standard Deviation 0.44	0.13 Emergency department visits Standard Deviation 0.54	0.14 Emergency department visits Standard Deviation 0.44	0.14 Emergency department visits Standard Deviation 0.75	0.21 Emergency department visits Standard Deviation 0.94

SECONDARY outcome

Timeframe: During 12 months pre-index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation.

Outpatient visits refers when participants visited hospital but not for formal admission. In this outcome measure, mean of number of outpatient visits related to RA during 12 months pre-index were evaluated.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=310 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=299 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=79 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=287 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=112 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=262 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Mean of Rheumatoid Arthritis Related Outpatient Visits During 12 Months Pre-index Date	7.83 Outpatient visits Standard Deviation 5.69	8.38 Outpatient visits Standard Deviation 5.45	7.90 Outpatient visits Standard Deviation 5.54	8.80 Outpatient visits Standard Deviation 5.66	7.19 Outpatient visits Standard Deviation 4.61	8.89 Outpatient visits Standard Deviation 5.22

SECONDARY outcome

Timeframe: During 12 months pre-index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation.

In this outcome measure, mean of number of pharmacy visits related to RA during 12 months pre-index were evaluated.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=310 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=299 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=79 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=287 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=112 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=262 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Mean of Rheumatoid Arthritis-Related Pharmacy Visits During 12 Months Pre-index Date	13.25 Pharmacy visits Standard Deviation 9.80	14.16 Pharmacy visits Standard Deviation 10.45	17.23 Pharmacy visits Standard Deviation 11.53	17.85 Pharmacy visits Standard Deviation 10.80	16.60 Pharmacy visits Standard Deviation 11.18	17.40 Pharmacy visits Standard Deviation 11.69

SECONDARY outcome

Timeframe: During 12 months post-index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation.

Inpatient visits refers when participants visited hospital for formal admission. In this outcome measure, mean of number of inpatient visits related to RA during 12 months post-index were evaluated.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=310 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=299 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=79 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=287 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=112 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=262 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Mean of Rheumatoid Arthritis Related Inpatient Visits During 12 Months Post-index Date	0.14 Inpatient visits Standard Deviation 0.42	0.10 Inpatient visits Standard Deviation 0.36	0.04 Inpatient visits Standard Deviation 0.19	0.08 Inpatient visits Standard Deviation 0.33	0.11 Inpatient visits Standard Deviation 0.47	0.08 Inpatient visits Standard Deviation 0.34

SECONDARY outcome

Timeframe: During 12 months post-index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation.

In this outcome measure, mean of number of emergency department visits related to RA during 12 months post-index were evaluated.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=310 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=299 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=79 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=287 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=112 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=262 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Mean of Rheumatoid Arthritis Related Emergency Department (ED) Visits During 12 Months Post-index Date	0.18 Emergency department visits Standard Deviation 0.48	0.12 Emergency department visits Standard Deviation 0.41	0.11 Emergency department visits Standard Deviation 0.39	0.08 Emergency department visits Standard Deviation 0.31	0.29 Emergency department visits Standard Deviation 1.75	0.23 Emergency department visits Standard Deviation 0.61

SECONDARY outcome

Timeframe: During 12 months post-index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation.

Outpatient visits refers when participants visited hospital but not for formal admission. In this outcome measure, mean of number of outpatient visits related to RA during 12 months post-index were evaluated.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=310 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=299 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=79 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=287 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=112 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=262 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Mean of Rheumatoid Arthritis Related Outpatient Visits During 12 Months Post-index Date	8.60 Outpatient visits Standard Deviation 7.17	8.14 Outpatient visits Standard Deviation 5.72	7.51 Outpatient visits Standard Deviation 5.53	8.06 Outpatient visits Standard Deviation 6.08	8.52 Outpatient visits Standard Deviation 6.68	8.88 Outpatient visits Standard Deviation 6.32

SECONDARY outcome

Timeframe: During 12 months post-index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation.

In this outcome measure, mean of number of pharmacy visits related to RA during 12 months post-index were evaluated.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=310 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=299 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=79 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=287 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=112 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=262 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Mean of Rheumatoid Arthritis Related Pharmacy Visits During 12 Months Post-index Date	18.76 Pharmacy visits Standard Deviation 10.77	17.86 Pharmacy visits Standard Deviation 11.08	19.80 Pharmacy visits Standard Deviation 11.74	18.57 Pharmacy visits Standard Deviation 10.57	20.13 Pharmacy visits Standard Deviation 11.15	19.08 Pharmacy visits Standard Deviation 10.59

SECONDARY outcome

Timeframe: During 12 months pre-index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation.

Inpatient visits refers when participants visited hospital for formal admission. In this outcome measure, mean of number of inpatient visits regardless of reason (including related to RA) during 12 months pre-index were evaluated.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=310 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=299 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=79 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=287 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=112 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=262 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Mean of All Cause Inpatient Visits During 12 Months Pre-Index Date	0.14 Inpatient visits Standard Deviation 0.39	0.17 Inpatient visits Standard Deviation 0.54	0.13 Inpatient visits Standard Deviation 0.43	0.15 Inpatient visits Standard Deviation 0.43	0.10 Inpatient visits Standard Deviation 0.46	0.16 Inpatient visits Standard Deviation 0.48

SECONDARY outcome

Timeframe: During 12 months pre-index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation.

In this outcome measure, mean of number of emergency department visits regardless of reason (including related to RA) during 12 months pre-index were evaluated.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=310 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=299 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=79 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=287 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=112 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=262 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Mean of All Cause Emergency Department (ED) Visits During 12 Months Pre-index Date	0.55 Emergency department visits Standard Deviation 0.95	0.47 Emergency department visits Standard Deviation 1.34	0.52 Emergency department visits Standard Deviation 1.27	0.47 Emergency department visits Standard Deviation 1.09	0.63 Emergency department visits Standard Deviation 2.76	0.60 Emergency department visits Standard Deviation 1.46

SECONDARY outcome

Timeframe: During 12 months pre-index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation.

Outpatient visits refers when participants visited hospital but not for formal admission. In this outcome measure, mean of number of outpatient visits regardless of reason (including related to RA) during 12 months pre-index were evaluated.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=310 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=299 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=79 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=287 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=112 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=262 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Mean of All Cause Outpatient Visits During 12 Months Pre-Index Date	31.70 Outpatient visits Standard Deviation 22.60	27.26 Outpatient visits Standard Deviation 19.81	28.48 Outpatient visits Standard Deviation 23.30	29.92 Outpatient visits Standard Deviation 20.62	27.23 Outpatient visits Standard Deviation 18.21	31.45 Outpatient visits Standard Deviation 22.50

SECONDARY outcome

Timeframe: During 12 months pre-index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation.

In this outcome measure, mean of number of pharmacy visits regardless of reason (including related to RA) during 12 months pre-index were evaluated.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=310 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=299 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=79 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=287 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=112 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=262 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Mean of All Cause Pharmacy Visits During 12 Months Pre-index Date	41.69 Pharmacy visits Standard Deviation 30.60	40.56 Pharmacy visits Standard Deviation 27.62	42.47 Pharmacy visits Standard Deviation 27.03	46.24 Pharmacy visits Standard Deviation 29.26	41.83 Pharmacy visits Standard Deviation 28.58	47.29 Pharmacy visits Standard Deviation 33.67

SECONDARY outcome

Timeframe: During 12 months post-index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation.

Inpatient visits refers when participants visited hospital for formal admission. In this outcome measure, mean of number of inpatient visits regardless of reason (including related to RA) during 12 months post-index were evaluated.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=310 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=299 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=79 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=287 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=112 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=262 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Mean of All Cause Inpatient Visits During 12 Months Post-index Date	0.24 Inpatient visits Standard Deviation 0.58	0.16 Inpatient visits Standard Deviation 0.53	0.14 Inpatient visits Standard Deviation 0.71	0.14 Inpatient visits Standard Deviation 0.48	0.24 Inpatient visits Standard Deviation 1.21	0.25 Inpatient visits Standard Deviation 0.87

SECONDARY outcome

Timeframe: During 12 months post-index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation.

In this outcome measure, mean of number of emergency department visits regardless of reason (including related to RA) during 12 months post-index were evaluated.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=310 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=299 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=79 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=287 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=112 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=262 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Mean of All Cause Emergency Department (ED) Visits During 12 Months Post-index Date	0.68 Emergency department visits Standard Deviation 1.25	0.41 Emergency department visits Standard Deviation 0.89	0.52 Emergency department visits Standard Deviation 0.96	0.44 Emergency department visits Standard Deviation 1.04	1.04 Emergency department visits Standard Deviation 7.23	0.81 Emergency department visits Standard Deviation 1.63

SECONDARY outcome

Timeframe: During 12 months post-index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation.

Outpatient visits refers when participants visited hospital but not for formal admission. In this outcome measure, mean of number of outpatient visits regardless of reason (including related to RA) during 12 months post-index were evaluated.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=310 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=299 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=79 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=287 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=112 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=262 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Mean of All Cause Outpatient Visits During 12 Months Post-index Date	33.30 Outpatient visits Standard Deviation 29.56	27.16 Outpatient visits Standard Deviation 21.30	27.00 Outpatient visits Standard Deviation 21.04	28.89 Outpatient visits Standard Deviation 22.48	28.39 Outpatient visits Standard Deviation 22.90	32.76 Outpatient visits Standard Deviation 27.14

SECONDARY outcome

Timeframe: During 12 months post-index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation.

In this outcome measure, mean of number of pharmacy visits regardless of reason (including related to RA) during 12 months post-index were evaluated.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=310 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=299 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=79 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=287 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=112 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=262 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Mean of All Cause Pharmacy Visits During 12 Months Post-index Date	49.32 Pharmacy visits Standard Deviation 34.05	45.25 Pharmacy visits Standard Deviation 28.85	46.33 Pharmacy visits Standard Deviation 27.41	47.70 Pharmacy visits Standard Deviation 30.26	45.70 Pharmacy visits Standard Deviation 27.46	50.09 Pharmacy visits Standard Deviation 31.99

SECONDARY outcome

Timeframe: During 12 months pre-index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation.

Total health care cost related to RA was calculated as sum of medical (outpatient, inpatient and emergency visit) cost and treatment costs (pharmacy cost) related to rheumatoid arthritis.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=310 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=299 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=79 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=287 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=112 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=262 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Mean of Rheumatoid Arthritis Related Total Health Care Cost During 12 Months Pre-index Date	6316.86 Dollars Standard Deviation 14673.52	7414.19 Dollars Standard Deviation 16892.85	16343.48 Dollars Standard Deviation 15762.03	27375.50 Dollars Standard Deviation 20613.83	18432.35 Dollars Standard Deviation 15754.60	22777.88 Dollars Standard Deviation 16633.19

SECONDARY outcome

Timeframe: During 12 months post-index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation.

Total health care cost related to RA was calculated as sum of medical (outpatient, inpatient and emergency visit) cost and treatment costs (pharmacy cost) related to rheumatoid arthritis.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=310 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=299 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=79 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=287 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=112 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=262 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
Mean of Rheumatoid Arthritis Related Total Health Care Cost During 12 Months Post-index Date	35601.32 Dollars Standard Deviation 22826.82	34503.47 Dollars Standard Deviation 31045.94	34010.25 Dollars Standard Deviation 17628.32	37431.71 Dollars Standard Deviation 21525.40	40027.03 Dollars Standard Deviation 20886.32	36963.17 Dollars Standard Deviation 18806.38

SECONDARY outcome

Timeframe: During 12 months pre-index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation.

All cause total health care cost was calculated as sum of medical (outpatient, inpatient and emergency visit) cost and treatment cost (pharmacy cost) regardless of reason including RA.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=310 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=299 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=79 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=287 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=112 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=262 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
All Cause Total Health Care Cost During 12 Months Pre-index Date	22626.74 Dollars Standard Deviation 43882.45	19514.09 Dollars Standard Deviation 29958.63	25944.31 Dollars Standard Deviation 21338.45	38749.72 Dollars Standard Deviation 28956.92	29643.91 Dollars Standard Deviation 31487.43	36152.42 Dollars Standard Deviation 30954.57

SECONDARY outcome

Timeframe: During 12 months post-index date

Population: Analysis was performed on all eligible participants whose data were retrieved from databases and included in the study for retrospective observation.

All cause total health care cost was calculated as sum of medical (outpatient, inpatient and emergency visit) cost and treatment cost (pharmacy cost) regardless of reason including RA.

Outcome measures

Measure	Tofacitinib Low OOP Cost n=310 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had low OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims database.	Tofacitinib High OOP Cost n=299 Participants Participants included in this reporting group were those who initiated tofacitinib between January 2014 and September 2016 and had high OOP cost (medical care expenses not reimbursed by insurance) as per data retrieved from insurance claims databases.	Switch From Adalimumab to Etanercept n=79 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to etanercept, as per data retrieved from insurance claims databases.	Switch From Adalimumab to Tofacitinib n=287 Participants Participants included in this reporting group were those who initiated adalimumab between January 2014 and September 2016, and in this same duration switched from adalimumab to tofacitinib as per data retrieved from insurance claims databases.	Switch From Etanercept to Adalimumab n=112 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to adalimumab, as per data retrieved from insurance claims databases.	Switch From Etanercept to Tofacitinib n=262 Participants Participants included in this reporting group were those who initiated etanercept between January 2014 and September 2016, and in this same duration switched from etanercept to tofacitinib, as per data retrieved from insurance claims databases.
All Cause Total Health Care Cost During 12 Months Post-index Date	56515.65 Dollars Standard Deviation 78961.26	46126.57 Dollars Standard Deviation 39998.62	50343.02 Dollars Standard Deviation 68582.27	49109.94 Dollars Standard Deviation 29561.43	56302.76 Dollars Standard Deviation 61613.45	56786.41 Dollars Standard Deviation 57000.99

Adverse Events

Tofacitinib Low OOP Cost

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Tofacitinib High OOP Cost

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Switch From Adalimumab to Etanercept

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Switch From Adalimumab to Tofacitinib

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Switch From Etanercept to Adalimumab

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Switch From Etanercept to Tofacitinib

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Pfizer ClinicalTrials.gov Call Center

Pfizer Inc.

Phone: 1-800-718-1021

Email: ClinicalTrials.gov_Inquiries@pfizer.com

Results disclosure agreements

• Principal investigator is a sponsor employee Pfizer has the right to review disclosures, requesting a delay of less than 60 days. Investigator will postpone single center publications until after disclosure of pooled data (all sites), less than 12 months from study completion/termination at all participating sites. Investigator may not disclose previously undisclosed confidential information other than study results.
• Publication restrictions are in place

Restriction type: OTHER