Background
The EULAR and ACR guidelines do not recommend any biological treatment above another in terms of efficacy. Thus financial aspects, such as the real associated cost, should be taken into account so that patients are offered the more efficient treatment and the best use is made of health resources.
Purpose
To analyse dose patterns and associated costs per patient per year (PPPY) of etanercept (ETN), adalimumab (ADA) and infliximab (IFX) in rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS) patients in clinical practice.
Materials and methods
An observational transversal study was performed including all patients with RA, PsA or AS treated with ETN, ADA or IFX for at least 6 months between January 2008 and April 2013.
Administered doses were calculated using individual claims data according to Pharmacy Department’ records, standardised and adjusted to a mean percentage of SmPC recommended doses (considered as 100%).
Temporary interruptions were taken into account.
Annual (52 weeks) costs were calculated using the Spanish ex-factory unitary prices of each agent: 494.6 € for 40 mg adalimumab, 227.8 € for 50 mg etanercept and 515.9 € for 100 mg infliximab, including tax (2013 €).
Results
451 patients were included (49.9% RA; 26.6% AS; 23.5% PsA). Anti-TNF distribution was: etanercept 37.5%; adalimumab 32.6%; infliximab 29.9%.
Dose, associated costs and suspension of treatment are shown in the table:
Similar results of antiTNF use in clinical practice have been already presented [1],[2].
Conclusions
The optimization of biological agents in certain clinically stable patients reduces mean administered doses and associated costs below the recommended ones, a trend not observed with infliximab.
The average cost PPPY associated with etanercept was significantly lower than that of adalimumab and infliximab.
References
Ramírez-Herráiz E, et al. Efficiency of adalimumab, etanercept and infliximab in rheumatoid arthritis patients: dosing patterns and effectiveness in daily clinical practice. Clin Exp Rheumatol 2013 Jul-Aug;31(4):559-65. Epub 2013 May 27
De la Torre, I, et al. Anti-TNF treatments in rheumatoid arthritis: economic impact of dosage modification. Expert Rev Pharmacoecon Outcomes Res 2013;13(3):407–414
Abstract CP-035 Table 1
Etanercept(n = 169)
Adalimumab(n = 147)
Infliximab(n = 135)
p
Average cost PPPY
10,980 €
11,949 €
14,554 €
<0.001 INF vs. ADA/ETN<0.05 ADA vs. ETN
Study real doses
92.44%
92.66%
138.19%
<0.001 INF vs. ADA/ETN
Definitive suspension
40.2%
36.7%
51.1%
<0.05 ETN/INF vs. ADA
No conflict of interest.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.