Intravenous golimumab and infliximab are both widely used in the treatment of rheumatoid arthritis (RA) in the United States, though these anti–tumor necrosis factor agents have markedly different dosing recommendations; patients who receive golimumab may receive 7 infusions during year 1, while patients who receive infliximab may receive between 8 and 14 infusions during year 1.
Intravenous golimumab and infliximab are both widely used in the treatment of rheumatoid arthritis (RA) in the United States, though these anti—tumor necrosis factor agents have markedly different dosing recommendations; patients who receive golimumab may receive 7 infusions during year 1, while patients who receive infliximab may receive between 8 and 14 infusions during year 1.
A recent study evaluated treatment patterns and infusion-related healthcare expenditures from a commercial payer perspective for matched RA cohorts starting each of the 2 drugs, and it found that golimumab saves on costs in RA relative to infliximab.
The retrospective, observational cohort study used administrative healthcare claims data from the MarketScan database. The matched golimumab and infliximab cohorts each contained 547 patients with RA who were initiating therapy. In a mean followup of 609 days (standard deviation [SD], 161 days), the mean treatment duration was 396 days (SD, 240 days) for the golimumab group and 397 days (SD, 239 days) for the infliximab group.
A total of 3961 golimumab and 4716 infliximab infusions were administered. The golimumab group received significantly fewer infusions compared with the infliximab group; the mean number of induction plus maintenance infusions per patient was 7.2 (SD, 4.3) for golimumab versus 8.6 (SD, 5.6) for infliximab (P = .018).
All claims were associated with billed infusion time; fewer than 1% of golimumab infusions, versus 96% of infliximab infusions, had claims for more than 1 hour of billed infusion time.
The total mean drug cost per infusion of golimumab was $5622 (SD, $3641) versus $5083 (SD, $4339) for infliximab. The mean administration cost per infusion was $224 (SD, $151) versus $360 (SD, $281), for the 2 treatments, respectively.
Estimated total costs per patient for the first year of therapy (based on real-world dosing and administration data, weighted maintenance infusion intervals, and commercial costs) were $41,104 for golimumab versus $51,611 for infliximab.
Furthermore, write the authors, while biosimilar infliximab was not present in the data set, “given the assumption that biosimilar [infliximab] would likely demonstrate similar dosing and administration patterns to originator [infliximab], we were able to confirm that [golimumab] treatment patterns observed in this study would be cost saving over biosimilar [infliximab] under commercial reimbursement scenarios.”
The study was funded by Janssen.
Ellis LA, Malangone-Monaco E, Varker H, et al. Comparative analysis of US real-world dosing patterns and direct infusion-related costs for matched cohorts of rheumatoid arthritis patients treated with infliximab or intravenous golimumab. Clinicoecon Outcomes Res. 2019;11:99-110. doi: 10.2147/CEOR.S185547.