Abstract
2 min readCrohn’s disease (CD) and ulcerative colitis (UC) often require life-long treatment (Tx). In Germany, approved biologic Tx includes vedolizumab (VDZ), a monoclonal anti-integrin antibody, and anti-TNFα; however, real-world comparative drug costs are poorly understood. A chart review study conducted June 2016 in Germany (15 sites), included UC and CD patients (patients) who were biologic naïve (bio-naïve) or received one prior anti-TNFα and initiated VDZ or anti-TNFα (infliximab-originator [IFX-O] or biosimilar [IFX-B], adalimumab [ADA] or golimumab [GOL, UC only]) from 15 July 2014 to 20 October 2015. Pt clinical characteristics and Tx patterns (schedule and dose strength or frequency modifications) were collected. Drug costs at 14 weeks, 6 and 12 months, and per year (yr) during maintenance (Tx post-week 14) were calculated using Lauer-Taxe list prices for patients on continuous Tx; a Student’s t-test assessed significance. Analyses include 140 UC (80 VDZ and 60 anti-TNFα [27 IFX-O, 6 IFX-B, 12 ADA, 15 GOL]) and 179 CD (72 VDZ and 107 anti-TNFα [46 IFX-O, 19 IFX-B, 42 ADA]) patients. Median years since diagnosis in UC VDZ and anti-TNFα patients was 6.6 and 4.4 years, 30% and 68% were bio-naïve, 76% and 65% used corticosteroids in the prior 2 years, median Tx duration was 16 and 14 months, and 33% and 23% had ≥1 dose escalation, respectively. Median years since diagnosis in CD VDZ and anti-TNFα patients was 8.5 and 5.3 years, 15% and 61% were bio-naïve, 60% and 64% used corticosteroids in the prior 2 years, median Tx duration was 15 and 15 months, and 24% and 31% had ≥1 dose escalation, respectively. Mean VDZ vs. anti-TNFα costs were lower in UC at 14 weeks (€8807 vs. €9663, p < 0.01), 6 months (€11879 vs. €14111, p < 0.01) and 12 months (€20430 vs. €23025, p = 0.02) and similar per yr in maintenance (€13017 vs. €15605, p = 0.10). In CD, costs were similar at 14 weeks (€9095 vs. €8835, p = 0.42), 6 months (€12278 vs. €12421, p = 0.75), 12 months (€20005 vs. €21394, p = 0.13) and per year in maintenance (€12515 vs. €13944, p = 0.09). VDZ mean maintenance costs per year were similar or lower vs. each anti-TNFα in UC (€13017 vs. IFX-O: €16315 [p = 0.07]; IFX-B: €26463 [p < 0.01]; ADA: €14041 [p = 0.52]; GOL: €11901 [p = 0.41]) and CD (€12515 vs. IFX-O: €14688 [p = 0.02]; IFX-B: €12088 [p = 0.75]; ADA: €13980 [p = 0.15]). VDZ mean maintenance costs per yr tended to be lower vs anti-TNFα in bio-naïve (UC: €14700 vs. €16261, p = 0.64; CD: €12628 vs. €13803, p = 0.54) and one prior anti-TNFα groups (UC: €12318 vs. €14185, p = 0.14; CD: €12495 vs. €14194, p = 0.11). Real-world biologic drug costs for UC and CD vary greatly in Germany. VDZ is associated with significantly lower costs in UC and numerically lower costs in CD vs. anti-TNFα over 1 year.
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