Switching Biologics Could Increase Costs

October 23, 2017

A poster presented at AMCP Nexus 2017 found that switching biologic products was associated with greater health care costs among patients with rheumatoid arthritis. 

Joseph Tkacz, MS, director of analytics at Health Analytics, explained that biologic switching happens for a myriad of reasons among patients with rheumatoid arthritis.

“Although biologics are effective in managing rheumatoid arthritis, many patients experience at least one biologic switch during treatment,” he wrote in the poster presentation. “Biologic switching may occur due to clinical or non-clinical reasons. Changes to treatment regimens, such as switching, can have clinical and cost implications.”

In order to determine how switching biologics among patients with rheumatoid arthritis impacts health care utilization and costs, Mr Tkacz and colleagues conducted a retrospective analysis of patient claims from 2009 to 2013. The study population only included patients with rheumatoid arthritis who were on biologics, with 6 months of pre-switch data and 1 year of post-switch data—or a total of 18 months data for patients who did not switch. Switchers were compared to nonswitchers to measure differences in utilization and costs.

Study results showed that patients who switched biologics utilized more health care services, including provider office visits, ED visits, and pharmacy services, compared to patients who did not switch. As a result, the researchers found that patients who switched had greater annual health care costs, at $41,482 per year compared to $36,321 among patients who did not switch.

Furthermore, patients who switched from anti-TNF medications to medications with other mechanism of action had significantly great outpatient, medical, pharmacy, and total health care costs, compared to patients who switched from anti-TNF medications to new anti-TNF medications.

“Biologic switching in rheumatoid arthritis is associated with increased health care costs,” the researchers concluded. “These findings indicate that switching agents, regardless of clinical or non-clinical reasons, may be accompanied by increased cost and utilization. Efforts to optimize patient response to initial biologic therapy and to reduce non-medical switching may help to mitigate costs.”

David Costill