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Abstract Number: 1030

Healthcare Service Utilization and Costs of Certolizumab Pegol Versus Infliximab Treatment in Patients with Rheumatoid Arthritis

Joseph Tkacz1, Edward Lee2, Robert Low2, Jeffrey Stark2, Mohamed Yassine2 and Brenna Brady1, 1Health Analytics LLC, Columbia, MD, 2UCB Pharma, Smyrna, GA

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: certolizumab pegol, Health care cost, infliximab, rheumatoid arthritis (RA) and treatment

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Session Information

Date: Monday, November 6, 2017

Session Title: Health Services Research Poster II: Osteoarthritis and Rheumatoid Arthritis

Session Type: ACR Poster Session B

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

Background/Purpose: Prior retrospective claims analyses examining rheumatoid arthritis (RA) treatment costs have shown infliximab (IFX) to be costlier than certolizumab pegol (CZP) across all sites of care (physician office, home, outpatient [OP]), primarily due to lower CZP drug costs.1 The present study assessed one-year (yr) healthcare resource utilization (HRU) and costs incurred by RA patients (pts) treated with CZP vs IFX.

Methods: Medical and pharmacy claims data (2008–2015) were derived from the Truven MarketScan® database of insured pts matching the inclusion criteria: RA diagnosis, treatment initiation (index date) with CZP or IFX (July/1/2008–December/31/2014), continuous eligibility ±12 months around index date, and age ≥18 yrs. Mean, unadjusted one-yr visits (OP, inpatient [IP], emergency room [ER], and physician office) and costs (pharmacy, medical, and total healthcare) were calculated and compared between groups via Mann-Whitney U tests. These were also assessed using multivariate (MV) regression models and adjusted for treatment (CZP/IFX), prior biologic use (yes/no), gender, age, baseline health, and baseline HRU and costs.

Results: 1,398 RA pts were treated with CZP and 3,592 with IFX. CZP pts were more likely to have prior biologic use than IFX pts (74.0% vs 40.8%, p<0.001; Table 1). In the unadjusted analyses, CZP pts demonstrated increased pharmacy usage (68.7 vs 56.1 fills per pt per yr, p<0.001), but reduced physician office visits (19.8 vs 21.9, p<0.001) and OP hospital-based services (4.4 vs 4.9, p=0.221) compared to IFX pts, resulting in greater overall pharmacy costs but lower medical expenditure than IFX patients (p values <0.001; Figure 1A). In adjusted analyses, MV models controlling for patient and treatment characteristics revealed that prior biologic use was associated with more office visits (p<0.001), OP visits (p<0.001), ER utilization (p<0.001), and elevated total medical costs (p<0.001). Despite the CZP cohort having more biologic-experienced pts, CZP treatment was associated with fewer physician office (p<0.001; Table 2) and OP (p<0.001; Table 2) services compared to IFX pts, but a greater pharmacy spend (p<0.001; Figure 1B). However, CZP treatment was associated with reduced total healthcare costs (p<0.001), with IFX pts incurring over $4,000 per pt per yr more than CZP pts ($46,908 vs $42,867, p<0.001; Figure 1B).

Conclusion: Despite the CZP-treated RA population having a higher rate of prior biologic use, which has been correlated with more severe disease,2 annual total healthcare costs were higher for IFX-treated RA pts. MV models controlling for demographics and baseline HRU revealed that treatment with CZP was associated with a $4,000 saving per pt per yr compared to treatment with IFX.

References:

1. Tkacz J. J Manag Care Spec Pharm 2016;22(Suppl10):S106(Abstract M12)

2. Harrold L. Arthritis Rheumatol 2016;68(Suppl10):3489–91


Disclosure: J. Tkacz, Health Analytics LLC, 3; E. Lee, UCB Pharma, 3; R. Low, UCB Pharma, 3; J. Stark, UCB Pharma, 3; M. Yassine, UCB Pharma, 3; B. Brady, Health Analytics LLC, 3.

To cite this abstract in AMA style:

Tkacz J, Lee E, Low R, Stark J, Yassine M, Brady B. Healthcare Service Utilization and Costs of Certolizumab Pegol Versus Infliximab Treatment in Patients with Rheumatoid Arthritis [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/healthcare-service-utilization-and-costs-of-certolizumab-pegol-versus-infliximab-treatment-in-patients-with-rheumatoid-arthritis/. Accessed February 2, 2023.
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