Table 3.
Estimated healthcare costs after versus before switch stratified by diagnosis and biosimilar drug.
| PsA | RA | AxSpA | ||||
|---|---|---|---|---|---|---|
| After | After | After | ||||
| Estimate (95% CI) | p | Estimate (95% CI) | p | Estimate (95% CI) | p | |
| GP2017 | ||||||
| Hospital costs | ||||||
| Musculoskeletal system and the connective tissue | 0.77 (0.69–0.85) | <0.001 | 0.92 (0.79–1.05) | 0.22 | 0.82 (0.76–0.89) | <0.001 |
| Other hospital costs | 0.98 (0.68–1.41) | 0.92 | 1.25 (0.82–1.90) | 0.29 | 1.73 (1.15–2.60) | 0.008 |
| Total hospital costs | 0.83 (0.75–0.92) | <0.001 | 0.99 (0.86–1.14) | 0.87 | 0.85 (0.77–0.93) | <0.001 |
| Primary sector | ||||||
| General practitioner | 0.94 (0.79–1.11) | 0.46 | 0.87 (0.77–0.99) | 0.04 | 1.14 (1.00–1.31) | 0.06 |
| Specialist | 1.04 (0.72–1.49) | 0.85 | 1.02 (0.76–1.37) | 0.91 | 1.58 (1.11–2.25) | 0.01 |
| Physiotherapist, chiropractor, and foot specialist | 1.05 (0.82–1.35) | 0.71 | 1.16 (1.03–1.30) | 0.01 | 1.05 (0.87–1.27) | 0.62 |
| Other | 0.93 (0.73–1.19) | 0.58 | 0.89 (0.72–1.10) | 0.27 | 0.73 (0.59–0.90) | 0.003 |
| Primary sector total costs | 1.00 (0.87–1.16) | 0.97 | 1.02 (0.93–1.12) | 0.64 | 1.14 (1.00–1.29) | 0.04 |
| Prescription medication | ||||||
| Pain medication | 0.96 (0.73–1.27) | 0.77 | 0.92 (0.74–1.14) | 0.43 | 1.02 (0.84–1.25) | 0.83 |
| Not pain medication | 1.26 (1.07–1.48) | 0.005 | 1.05 (0.91–1.23) | 0.49 | 1.03 (0.88–1.21) | 0.69 |
| Prescription medication total costs | 1.20 (1.04–1.39) | 0.01 | 1.04 (0.91–1.19) | 0.56 | 1.04 (0.90–1.19) | 0.62 |
| Total healthcare costs | 0.85 (0.78–0.93) | <0.001 | 0.99 (0.87–1.13) | 0.89 | 0.86 (0.79–0.94) | <0.001 |
| SB5 | ||||||
| Hospital costs | ||||||
| Musculoskeletal system and the connective tissue | 1.05 (0.96–1.15) | 0.26 | 1.00 (0.94–1.07) | 0.99 | 1.00 (0.93–1.07) | 0.92 |
| Other hospital costs | 1.02 (0.73–1.45) | 0.89 | 1.08 (0.71–1.64) | 0.71 | 0.95 (0.54–1.67) | 0.86 |
| Total hospital costs | 1.03 (0.95–1.13) | 0.46 | 1.00 (0.93–1.08) | 0.97 | 1.01 (0.91–1.12) | 0.92 |
| Primary sector | ||||||
| General practitioner | 0.96 (0.83–1.11) | 0.54 | 0.97 (0.87–1.07) | 0.49 | 1.01 (0.89–1.16) | 0.84 |
| Specialist | 1.02 (0.58–1.81) | 0.93 | 0.94 (0.71–1.26) | 0.69 | 0.94 (0.60–1.46) | 0.78 |
| Physiotherapist, chiropractor, and foot specialist | 0.98 (0.83–1.17) | 0.84 | 1.09 (0.98–1.21) | 0.10 | 0.95 (0.86–1.04) | 0.26 |
| Other | 0.87 (0.74–1.03) | 0.11 | 0.97 (0.86–1.11) | 0.68 | 0.74 (0.56–0.97) | 0.03 |
| Primary sector total costs | 0.99 (0.88–1.12) | 0.90 | 1.02 (0.96–1.10) | 0.49 | 0.94 (0.86–1.02) | 0.15 |
| Prescription medication | ||||||
| Pain medication (DDD) | 0.92 (0.83–1.02) | 0.10 | 0.98 (0.88–1.10) | 0.76 | 0.98 (0.85–1.12) | 0.73 |
| Not pain medication (DDD) | 1.02 (0.93–1.11) | 0.74 | 1.13 (1.02–1.26) | 0.02 | 0.96 (0.87–1.06) | 0.40 |
| Prescription medication total costs (DDD) | 1.00 (0.93–1.08) | 0.95 | 1.11 (1.01–1.23) | 0.03 | 0.96 (0.88–1.04) | 0.31 |
| Total healthcare costs | 1.03 (0.95–1.11) | 0.48 | 1.01 (0.94–1.08) | 0.85 | 1.00 (0.91–1.10) | 0.99 |
a
Results of the GLM model (after = 1) adjusted for sex, age, number of years treated with originator drug (>6 years = 1), stopped the medication within 180 days (yes–no), and comorbidity (number of WHO 21 chapters excluding WHO 13 ICD-10 M (musculoskeletal diseases)). Values in bold indicate statistically significant results.
AxSpA, axial spondyloarthritis; DDD, defined daily dose; PsA, psoriatic arthritis; RA, rheumatoid arthritis.