Session Type: Poster Session (Monday)
Session Time: 9:00AM-11:00AM
Background/Purpose: Rheumatic diseases are associated with pain, loss of functionality, fatigue, hospitalization, sick leave, and work disability. This results in high economic burden for patients and society.Golimumab (GLM) is an effective but costly treatment option for patients with moderate to severe, active rheumatic diseases.
The aim of this analysis of the GO-NICE study was to investigate the direct and indirect costs of healthcare utilization and sick leave after starting a treatment with GLM.
Methods: Data from outpatients collected in the non-observational study GO-NICE in 1,483 patients with RA (n = 474), PsA (n=501), and AS (n=483) in 158 sites (2010-2015) in Germany were analysed. Details on the study design, patient characteristics, clinical and patient-reported outcomes, and safety data have been reported earlier [1,2].
Direct medical and indirect costs per patient and year were calculated for consultations, physiotherapy, massages, hospitalisations and inpatient rehabilitation, medication (DMARDs, Glucocorticoids, NSAIDs, and biologics) as well as sick leave days. Findings were shown for RA-, PsA- and AS-patients and categorised by biologic-naïve patients and patients previously treated with a biologic argent. The 6-month periods prior baseline (BL) / start of a GLM therapy vs. month 24 (M24) were compared.
For this calculation standardized evaluation rates were used (Bock et al. (2015), AG MEG of the DGSMP (2005). Costs for prescribed and documented medication were calculated by the mean cost per defined daily dose (based 2010-2015). Indirect costs were estimated through the human capital approach (HCA).
Results: Data from 758 biologic-naïve patients (n = 265 RA, 247 PsA and 246 AS) and 694 patients with biologics as pre-therapy (n = 208 RA, 252 PsA and 234 AS) were included in the analysis.
Direct medical costs (excluding medication) decreased in all 6 groups, min. 765€ (PsA pre-treatment group) and max. 2,426€ (AS pre-treatment) as well as the costs due to work disability / absenteeism, min. 855€ (PsA pre-treatment) and max. 2.564€ (RA pre-treatment, table).
Total costs in biological-naïve patients increased due to the additional expense of the biologic agent.
Absolute changes in costs totalled 15,665€ (RA-, table), 15,799€ (PsA-) and 14,764€ (AS-patients) per patient and year when comparing the BL vs. M24 periods.
Total savings of 6,289€ (RA-, table), 2,617€ (PsA-), and 5,555€ (AS-patients) per patient and year were observed in the group of biologic-pre-treated patients.
Conclusion: Costs of healthcare utilization, as well as work disability, decreased after starting GLM within an observation period of 24 months, for patients with RA, PsA, and AS.
Due to the high costs of TNFi therapy, drug costs in the group of biologic-naive patients rose markedly. Savings were observed in the group of patients previously treated with a biologic argent.
To cite this abstract in AMA style:Krüger K, Burmester G, Wassenberg S, Thiele A, Thomas M. Golimumab Improves Direct Costs of Healthcare Utilization and Indirect Costs Within Patients with RA, PsA, and as – Analysis of a Non-Interventional Study in Germany [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/golimumab-improves-direct-costs-of-healthcare-utilization-and-indirect-costs-within-patients-with-ra-psa-and-as-analysis-of-a-non-interventional-study-in-germany/. Accessed January 18, 2020.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/golimumab-improves-direct-costs-of-healthcare-utilization-and-indirect-costs-within-patients-with-ra-psa-and-as-analysis-of-a-non-interventional-study-in-germany/