Cost per Response for Abatacept Versus Adalimumab in Patients with Seropositive, Erosive, Early Rheumatoid Arthritis in the US, Germany, Spain and Canada

J Foo¹, JM Rodriguez Heredia², C Polanco Sánchez³, M Mtibaa⁴, KH Herrmann⁵, E Alemao⁶, R Postema⁷ and C Baerwald⁸, ¹Mapi Group, Houten, Netherlands, ²Hospital Universitario de Getafe, Madrid, Spain, ³Bristol-Myers Squibb, Madrid, Spain, ⁴Bristol-Myers Squibb, Montréal, QC, Canada, ⁵Bristol-Myers Squibb, Munich, Germany, ⁶Bristol-Myers Squibb, Princeton, NJ, ⁷Bristol-Myers Squibb, Uxbridge, United Kingdom, ⁸University Hospital, Department of Internal Medicine, Rheumatology Unit, Leipzig, Germany

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: abatacept and remission, Biologics, DMARDs, Early Rheumatoid Arthritis

Session Information

Date: Monday, November 6, 2017

Title: Rheumatoid Arthritis – Small Molecules, Biologics and Gene Therapy Poster II: Prognostic Factors, Imaging and Miscellaneous Reports

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: RA is a chronic, inflammatory disorder leading to disability and reduced quality of life. Effective treatment with biologic DMARDs poses a significant economic burden. The Abatacept versus adaliMumab comParison in bioLogic-naïvE RA subjects with background methotrexate (AMPLE) trial was a head-to-head, randomized study comparing SC abatacept with SC adalimumab.¹A recent post hoc analysis showed improved efficacy for abatacept in patients with seropositive, erosive early RA (defined as: disease duration ≤6 months, RF or anti-citrullinated protein antibody seropositivity and >1 radiographic erosion) compared with adalimumab.² Methods: A previously published decision tree³ was used to compare the cost per response of abatacept and adalimumab in a cohort of 1000 patients over a 2-year time horizon. Clinical inputs were based on a post hoc analysis of the AMPLE trial in patients with or without seropositive, erosive early RA. Response was based on ACR20/50/70/90 and HAQ-DI. Unit costs for direct medical costs of AEs were based on local tariffs for disease-related groups and the ex-manufacturer price, including mandatory reductions, pay-back and transparent discounts for drugs. Results: The cost per response in patients with seropositive, erosive early RA favored SC abatacept compared with SC adalimumab for ACR20, ACR50, ACR70, ACR90 and HAQ-DI across all countries (Table). Cost per ACR90 and HAQ-DI response consistently favored SC abatacept in patients with or without seropositive, erosive early RA in all countries. The cost per CDAI and SDAI remission also favored SC abatacept in patients with seropositive, erosive early RA in all countries; however, the cost per DAS28 remission favored SC adalimumab in the US and Canada. Results in patients without seropositive, erosive early RA were less consistent for SC abatacept, except in Germany and Spain where the cost of abatacept is lower than the cost of adalimumab.

Conclusion: The cost per responder favored SC abatacept in patients with seropositive, erosive early RA. Cost savings can be achieved through the use of abatacept over adalimumab in patients with early, rapidly progressing RA in the US, Germany, Spain and Canada. 1. Schiff M, et al. Ann Rheum Dis 2014;73:86–94. 2. Fleischmann R, et al. Ann Rheum Dis 2017;76(Suppl 2). doi: 10.1136/annrheumdis-2017-eular.3521. 3. Weijers L, et al. Rheumatol Int 2017 May 30. doi: 10.1007/s00296-017-3739-9.

Disclosure: J. Foo, Bristol-Myers Squibb, 5; J. Rodriguez Heredia, None; C. Polanco Sánchez, Bristol-Myers Squibb, 3; M. Mtibaa, Bristol-Myers Squibb, 9,Bristol-Myers Squibb, 3; K. Herrmann, Bristol-Myers Squibb, 1,Bristol-Myers Squibb, 3; E. Alemao, Bristol-Myers Squibb, 3,Bristol-Myers Squibb, 1; R. Postema, Bristol-Myers Squibb, 1,Bristol-Myers Squibb, 3; C. Baerwald, AbbVie, BMS, Chugai, MSD, Pfizer, Roche, UCB, 5,AbbVie, BMS, Chugai, MSD, Pfizer, Roche, UCB, 8.

To cite this abstract in AMA style:

Foo J, Rodriguez Heredia J, Polanco Sánchez C, Mtibaa M, Herrmann K, Alemao E, Postema R, Baerwald C. Cost per Response for Abatacept Versus Adalimumab in Patients with Seropositive, Erosive, Early Rheumatoid Arthritis in the US, Germany, Spain and Canada [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/cost-per-response-for-abatacept-versus-adalimumab-in-patients-with-seropositive-erosive-early-rheumatoid-arthritis-in-the-us-germany-spain-and-canada/. Accessed .

« Back to 2017 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/cost-per-response-for-abatacept-versus-adalimumab-in-patients-with-seropositive-erosive-early-rheumatoid-arthritis-in-the-us-germany-spain-and-canada/