Nadkarni Anagha, McMorrow Donna, Patel Chad, Fowler Robert, Smith David
Bristol-Myers Squibb, 777 Scudders Mill Road, Plainsboro, NJ 08536, USA.
Truven Health Analytics, 75 Binney Street, Cambridge, MA 02142, USA.
J Comp Eff Res. 2017 Nov;6(8):671-682. doi: 10.2217/cer-2016-0090. Epub 2017 Aug 9.
Evaluation of dose escalation and costs among rheumatoid arthritis patients treated with intravenous abatacept, intravenous infliximab or intravenous tocilizumab.
MATERIALS & METHODS: Adults with rheumatoid arthritis and biologic treatment were identified from the MarketScan Research databases. Study outcomes included dose escalation, per-patient per-month (PPPM) biologic costs and PPPM all-cause total healthcare costs. Impact of dose escalation on biologic costs was estimated using multivariate analyses.
The sample included 6181 patients. Infliximab and tocilizumab cohorts had significantly higher likelihood for dose escalation than abatacept cohort; incremental PPPM impacts of dose escalation on costs were statistically significant for each biologic (p < 0.01).
Patients initiating abatacept were least likely to escalate dose and had lowest incremental impact of dose escalation on cost compared with patients with infliximab or tocilizumab.
评估接受静脉注射阿巴西普、静脉注射英夫利昔单抗或静脉注射托珠单抗治疗的类风湿性关节炎患者的剂量递增情况及成本。
从MarketScan研究数据库中识别出接受生物治疗的成年类风湿性关节炎患者。研究结果包括剂量递增、每位患者每月（PPPM）的生物制剂成本以及PPPM全因总医疗成本。使用多变量分析评估剂量递增对生物制剂成本的影响。
样本包括6181名患者。英夫利昔单抗和托珠单抗队列的剂量递增可能性显著高于阿巴西普队列；每种生物制剂的剂量递增对成本的PPPM增量影响具有统计学意义（p < 0.01）。
与接受英夫利昔单抗或托珠单抗治疗的患者相比，开始使用阿巴西普治疗的患者剂量递增可能性最小，且剂量递增对成本的增量影响最低。
