A study presented at the recent ISPOR 2019 meeting assessed both the cost associated with treatment with infliximab for patients at US hospitals as well as reasons for discontinuation of therapy during follow-up, and it found that insurance coverage status is one factor that plays a role in discontinuation of this therapy that rose consistently in price over the study period.
All biologic therapies that treat rheumatoid arthritis (RA) and other inflammatory diseases carry the potential for patients to have primary nonresponse, an outcome that leads to discontinuation of the biologic and potentially a switch to a different agent. Such treatment cycling is costly, and it is also associated with reduced efficacy. However, other factors, besides nonresponse, can also be involved in discontinuation.
A study presented at the recent ISPOR 2019 meeting assessed both the cost associated with treatment with infliximab for patients at US hospitals as well as reasons for discontinuation of therapy during follow up, and it found that insurance coverage status is one factor that plays a role in discontinuation of this therapy that rose consistently in price over the study period.
Using the Premier Healthcare Database, researchers identified 4373 patients with RA at 359 US hospitals between 2012 and 2015. All patients had at least 1 infliximab charge, had at least 1 outpatient visit during a 12-month lookback period, and had 2 or more outpatient visits during a 12-month follow-up. Infliximab use was classified as “new start” or “continued” based on whether infliximab was initiated after or before the lookback period, respectively.
In total, 2850 patients were new infliximab starts, and 1523 were continuing infliximab. New starters were more likely to be female, nonwhite, and treated in nonteaching hospitals.
The average infliximab annual cost was estimated to be $18,602 for the overall sample and was higher among continued-treatment patients as well as patients in the Midwest and Northeast. Between 2012 and 2015, the average infliximab cost per patient per year increased by $1066.
New starts discontinued infliximab more frequently (40.5%) than continued users (32.2%). Risk factors for discontinuation included younger age, being a new start, having public or no insurance at index, losing insurance coverage, and having pneumonia during the follow-up period.
Annual infliximab treatment costs are high, concluded the authors, with a 5.7% increase in costs each year, and strong predictors of discontinuation exist. The authors write that clinicians and pharmacists may need to monitor patients who are being treated with infliximab to ensure that they benefit from therapy as much as possible and avoid unnecessary discontinuation.
Reference
Rosenthal N, Wu D, Arsever C, Kartashov A, Baumer D. Infliximab costs and reasons for treatment discontinuation among patients with rheumatoid arthritis receiving treatment in US hospitals—2012-2015. Presented at: International Society for Pharmacoeconomics and Outcomes Research 24th Annual International Meeting; May 18-22, 2019; New Orleans, Louisiana. Abstract PMS11.
AMCP Posters Tackle Interchangeability and Medicaid, Factors Driving Biosimilar Access
April 24th 2024Two posters from the Academy of Managed Care Pharmacy (AMCP) annual meeting explore how an interchangeable insulin glargine biosimilar plays into Medicaid budgets and the top factors driving access to biosimilars.
Decoding the Patent Puzzle: Navigating the Legal Landscape of Biosimilars
March 17th 2024On this episode of Not So Different, Ha Kung Wong, JD, an intellectual patent attorney and partner at Venable LLP, details the confusing landscape that is the US patent system and how it can be improved to help companies overcome barriers to biosimilar competition.
Julie Reed: Why 2024 Is Important for Biosimilars
April 17th 2024Julie Reed, executive director of the Biosimilars Forum, showcases how the biosimilar industry is expected to develop throughout 2024, including major policy changes and hope for continued improvement in market share for adalimumab biosimilars.
Biosimilars Rheumatology Roundup for February 2024—Podcast Edition
March 3rd 2024On this episode of Not So Different, The Center for Biosimilars® revisited all the major rheumatology biosimilar news from February 2024, including the FDA approval of the 10th adalimumab biosimilar, the promise for an oral delivery system for ustekinumab, and the impact of adalimumab products on COVID-19 antibodies.
Alvotech’s Stelara Biosimilar, Selarsdi, Receives FDA Approval
April 16th 2024Alvotech’s Selarsdi (ustekinumab-aekn), a biosimilar referencing Stelara (ustekinumab), gained FDA approval, making it the second ustekinumab biosimilar and second for the company to be given the green light for the American market.
What Clinicians Need to Know About Using Biosimilars to Treat IBD
April 13th 2024A review article, intended to act as a guide for clinicians, summarizes the available infliximab and adalimumab biosimilars for treating inflammatory bowel disease (IBD) as well as others that are coming down the pipeline.