Null Kyle, Kumar Varun, Lissoos Trevor, Luo Michelle
a Takeda Pharmaceuticals USA Inc. , Deerfield , IL , USA.
b Institute for Clinical and Economic Review , Boston , MA , USA.
J Med Econ. 2018 Nov;21(11):1102-1109. doi: 10.1080/13696998.2018.1511568. Epub 2018 Sep 3.
Increasing use of biologics has led to interest in treatment components with potential for cost savings. This study was aimed at comparing administration times and associated costs of infliximab and vedolizumab infusions for inflammatory bowel disease (IBD).
This study used claims data from the Symphony Health Integrated Dataverse to identify IBD patients using infliximab or vedolizumab between 20 May 2014 and 29 February 2016. Use of Current Procedural Terminology administration codes was evaluated and costs calculated using the 2016 Center for Medicare and Medicaid Services Physician Fee Schedule. Assessments included infusion times, associated costs, productivity loss using average wage estimates from the United States Bureau of Labor Statistics, and home infusion adoption.
A total of 10,051 infliximab and 3114 vedolizumab patients with first-hour claims were identified; 52.0% were female and 64.5% had Crohn's disease. There were 48,377 infliximab first-hour claims (mean 4.8 infusions per patient); 46,462 (96.0%) had a second-hour claim. In comparison, there were 14,717 vedolizumab claims (mean 4.7 infusions per patient), with only 411 (2.8%) second-hour claims, resulting in vedolizumab cost savings of approximately $1.27 million. The difference in second-hour infusions resulted in 46,051 additional hours of productivity loss with infliximab, and lost wages averaging $1.18 million (range $0.68-$1.77 million).
Administration costs were inferred as charge costs and not directly assessed. Productivity loss assessed time spent on infusion only, and included a small proportion of patients beyond working age.
Second-hour infusion billing was significantly lower with vedolizumab than with infliximab, corresponding to cost savings and reduced productivity loss.
生物制剂使用的增加引发了人们对具有潜在成本节约潜力的治疗组成部分的兴趣。本研究旨在比较英夫利昔单抗和维多珠单抗治疗炎症性肠病（IBD）的输注时间及相关成本。
本研究使用了来自Symphony Health综合数据集的理赔数据，以识别2014年5月20日至2016年2月29日期间使用英夫利昔单抗或维多珠单抗的IBD患者。评估了现行程序术语管理代码的使用情况，并使用2016年医疗保险和医疗补助服务中心医生费率表计算成本。评估内容包括输注时间、相关成本、使用美国劳工统计局平均工资估计值计算的生产力损失以及家庭输注采用情况。
共识别出10,051名有首次输注理赔的英夫利昔单抗患者和3,114名维多珠单抗患者；52.0%为女性，64.5%患有克罗恩病。有48,377次英夫利昔单抗首次输注理赔（平均每位患者4.8次输注）；46,462次（96.0%）有第二次输注理赔。相比之下，有14,717次维多珠单抗理赔（平均每位患者4.7次输注），只有411次（2.8%）第二次输注理赔，维多珠单抗节省成本约127万美元。第二次输注的差异导致英夫利昔单抗多造成46,051小时的生产力损失，平均工资损失118万美元（范围为68万美元至177万美元）。
管理成本是推断的收费成本，未直接评估。生产力损失仅评估了输注所花费的时间，且包括一小部分超过工作年龄的患者。
维多珠单抗的第二次输注计费明显低于英夫利昔单抗，相应地节省了成本并减少了生产力损失。
