Does Etanercept Biosimilar Prescription in a Rheumatology Center Bend the Medication Cost Curve?

Autor:	Müskens WD; W.D. Müskens, MD, MSc, Department of IQ Healthcare, Radboudumc, Nijmegen; wieland.muskens@radboudumc.nl., Rongen-van Dartel SAA; S.A. Rongen-van Dartel, PhD, P.L. van Riel, MD, PhD, Department of IQ Healthcare, Radboudumc, Nijmegen, and Department of Rheumatology, Bernhoven, Uden., van Riel PLCM; S.A. Rongen-van Dartel, PhD, P.L. van Riel, MD, PhD, Department of IQ Healthcare, Radboudumc, Nijmegen, and Department of Rheumatology, Bernhoven, Uden., Adang EMM; E.M. Adang, PhD, Department of Health Evidence, Radboudumc, Nijmegen, the Netherlands.
Jazyk:	angličtina
Zdroj:	The Journal of rheumatology [J Rheumatol] 2021 Dec; Vol. 48 (12), pp. 1803-1809. Date of Electronic Publication: 2020 Nov 01.
DOI:	10.3899/jrheum.200565
Abstrakt:	Objective: The market entry of biosimilars is expected to bring budgetary relief. Our objective was to determine how the introduction of biosimilars influences medication costs in patients with rheumatoid arthritis (RA) and which patients gain access to biologics due to the availability of biosimilars. Methods: Using hospital data of patients with RA between 2014 and 2018, an interrupted time series was performed. The interruption in the time series was placed at June 2016 (i.e., the introduction of the etanercept biosimilar). The changes in trends for rheumatic medication costs before and after the interruption were measured. Secondary analyses focused on explaining these trends. Results: In the first quarter after the interruption, there was a decrease in total costs for biologic users of -€63,020 (95% CI -€96,487 to -€29,553, P = 0.001). The postinterruption trend did not differ from the preinterruption trend (95% CI -€6695 to €6715, P = 0.998) and after 3 quarters, the medication costs were back at the interruption level. After the interruption, the average cost per biologic user decreased by -€370 (95% CI -€602 to -€138, P = 0.005), followed by a quarterly decrease (relative to the preinterruption trend; 95% CI -€86 to -€14, P = 0.010), bending the average cost curve. The percentage of patients being treated with biologics increased in postinterruption by 0.50 percentage points quarterly (95% CI 0.38-0.62, P < 0.001). Also, the average age at the start of the first biologic increased after the interruption ( P = 0.057). Conclusion: The average cost per patient treated with biologics decreased after the introduction of biosimilars with a persistent trend. However, the budgetary relief due to market entry of biosimilars vanished quickly due to an increase in patients treated with biologics. (Copyright © 2021 by the Journal of Rheumatology.)
Databáze:	MEDLINE
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