Ellis Lorie A, Malangone-Monaco Elisabetta, Varker Helen, Stetsovsky Diana, Kubacki Maureen, DeHoratius Raphael J, Kafka Shelly
Real World Value and Evidence, Janssen Scientific Affairs, LLC, Horsham, PA, USA.
Life Sciences, IBM Watson Health, Armonk, NY, USA,
Clinicoecon Outcomes Res. 2019 Jan 15;11:99-110. doi: 10.2147/CEOR.S185547. eCollection 2019.
The objectives of this study were to evaluate and compare treatment patterns and infusion-related health care resource expenditures for rheumatoid arthritis (RA) patients initiating golimumab for intravenous use (GLM-IV) and infliximab (IFX) therapy and to assess cost implications from the commercial perspective.
Adult RA patients with a new episode of GLM-IV or IFX treatment between Janu-ary 1, 2014 and March 31, 2016 were identified from MarketScan databases and evaluated for maintenance infusion intervals and related costs of treatment. IFX and GLM-IV patients were matched 1:1 on index medication treatment duration, gender, payer type, prior biologic use, and post-index methotrexate use. Paid amounts for drugs and associated administration costs were applied to treatment group dosing patterns.
Final matched treatment groups included 547 GLM-IV and 547 IFX patients (mean age = 55-56 years). Mean (SD) follow-up was 609 (161) days for GLM-IV and 613 (163) days for IFX. Treatment duration was 396 (240) days for GLM-IV and 397 (239) days for IFX. Overall, 80% of GLM-IV and 39% of IFX maintenance infusions were given approximately every 8 weeks; and 6% of GLM-IV and 53% of IFX maintenance infusions occurred more frequently than every 8 weeks (<0.001). When weighting of the maintenance infusion interval was applied, the mean number of induction plus maintenance infusions during the first year of treatment was estimated at 7.03 for GLM-IV and 9.48 for IFX. From the commercial perspective, drug plus administration costs per infusion were $5,846 for GLM-IV and $5,444 for IFX with total annual cost of therapy for GLM-IV patients costing $10,507 less than that for IFX patients in the first year and $6,774 less than that for IFX patients in subsequent years.
Annual GLM-IV drug plus administration costs for commercial health plans were significantly less than IFX in RA patients due to differences in real-world dosing and administration.
本研究的目的是评估和比较开始使用静脉注射戈利木单抗(GLM-IV)和英夫利昔单抗(IFX)治疗的类风湿性关节炎(RA)患者的治疗模式和输液相关医疗保健资源支出,并从商业角度评估成本影响。
从MarketScan数据库中识别出2014年1月1日至2016年3月31日期间开始新的GLM-IV或IFX治疗的成年RA患者,并评估维持输液间隔和相关治疗成本。IFX和GLM-IV患者在索引药物治疗持续时间、性别、付款人类型、先前生物制剂使用情况和索引后甲氨蝶呤使用情况方面按1:1匹配。将药物支付金额和相关给药成本应用于治疗组给药模式。
最终匹配的治疗组包括547例GLM-IV患者和547例IFX患者(平均年龄=55 - 56岁)。GLM-IV的平均(标准差)随访时间为609(161)天,IFX为613(163)天。GLM-IV的治疗持续时间为396(240)天,IFX为397(239)天。总体而言,80%的GLM-IV维持输液和39%的IFX维持输液大约每8周进行一次;6%的GLM-IV维持输液和53%的IFX维持输液比每8周更频繁(<0.001)。当应用维持输液间隔权重时,治疗第一年诱导加维持输液的平均次数估计GLM-IV为7.03次,IFX为9.48次。从商业角度来看,GLM-IV每次输液的药物加给药成本为5846美元,IFX为5444美元,GLM-IV患者第一年的年度治疗总成本比IFX患者少10507美元,后续年份比IFX患者少6774美元。
由于实际给药和给药方式的差异,商业健康计划中RA患者的年度GLM-IV药物加给药成本显著低于IFX。