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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

Authors Ellis LA, Malangone-Monaco E, Varker H, Stetsovsky D, Kubacki M, DeHoratius RJ, Kafka S

Received 28 August 2018

Accepted for publication 20 November 2018

Published 15 January 2019 Volume 2019:11 Pages 99—110

DOI https://doi.org/10.2147/CEOR.S185547

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 3

Editor who approved publication: Professor Samer Hamidi


Lorie A Ellis,1 Elisabetta Malangone-Monaco,2 Helen Varker,3 Diana Stetsovsky,3 Maureen Kubacki,1 Raphael J DeHoratius,1,4 Shelly Kafka1

1Real World Value and Evidence, Janssen Scientific Affairs, LLC, Horsham, PA, USA; 2Life Sciences, IBM Watson Health, Armonk, NY, USA; 3Life Sciences, IBM Watson Health, Cambridge, MA, USA; 4Janssen Immunology, Medical Affairs, Sidney Kimmel School of Medicine, Thomas Jefferson University, Philadelphia, PA, USA

Purpose: 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.
Methods: Adult RA patients with a new episode of GLM-IV or IFX treatment between January 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.
Results: 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 (P<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.
Conclusion: 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.

Keywords: rheumatoid arthritis, infliximab, golimumab, dosing, treatment patterns

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