Table 3.
Reported drug and healthcare resource utilization costs
| Disease | Citation | Publication type | Drug | Cohort size | Data source | Switch programme | Drug-related costs and savings (2020 $C) | Overall costs and savings (2020 $C) | Inputs for overall cost and savings |
|---|---|---|---|---|---|---|---|---|---|
| Dermatology | |||||||||
| Psoriasis | Szlumper [9] | Abstract | Etanercept | 17 | Registry data | NS | NR |
Savings: £10,080 ($C18,383) over 3 months Projected savings: £131,040/year ($C238,984/year) |
NR |
| Gastroenterology | |||||||||
| CD | Ala [50] | Abstract | Infliximab | 20 | Hospital data | NS | NR | Savings: £220, 000/year ($C441,613) | NR |
| CD | Plevris [45] | Journal Article | Infliximab | 110 | IBD Centers data | Yes |
For 756 infusions, total cost: Remicade: £1,135,134 ($C1,974,759) CT-P13: £608,315 ($C1,058,267) cost savings of 46.4% |
NR | NA |
| IBD | O'Brien [84] | Abstract | Infliximab | 20 | Hospital data | NS | NR |
15% discount: €76,638 savings ($C118,850) 45% discount: €180,099 savings ($C279,296) No discount rate: 25% savings |
NR |
| CD, UC | Diaz Hernandez [52] | Abstract | Infliximab | 72 | Hospital data | NS | NR | Savings: 26% over 6 months | NR |
| CD, UC | Fischer [53] | Abstract | Infliximab | 114 | Hospital data | NS |
Savings: €354,137.88/6 months ($C549,194) |
NR | NA |
| CD, UC | Geccherle [85] | Abstract | Infliximab | 5 | NR | NS | NR |
Savings: €79,125 ($C125,502) in 6 months, not specific to post-NMS |
NR |
| CD, UC | Rahmany [38] | Abstract | Infliximab | 78 | Trust data | Yes | NR |
Savings: £232,576.52/6 months ($C466,858) Staff costs: £90,000 ($C180,660) |
NR |
| CD, UC | Rodriguez Glez [56] | Abstract | Infliximab | 72 | Hospital data | NS |
Savings: €248,716/year ($C394,493) |
NR | NA |
| CD, UC | St Clair Jones [39] | Abstract | Infliximab | 71 | Hospital data | Yes |
Savings: £224,000/year ($C355,291) |
Savings: £300,000/year ($C475,836) Switch Programme: funding of £1250/patient was required ($C1,983) | Drug costs including cost of treatment discontinuation, treatment switch, dose (de)escalation, and lab tests |
| CD, UC, IBDU | Huoponen [35] | Journal Article | Infliximab | 54 | Hospital data | NS |
Pre- vs post-switch annual drug costs CD: €11,784 vs €4163 ($C18,691 vs $C6603) UC/IBDU: €8978 vs €3568 ($C14,240 vs ($C5659) |
Pre- vs post-switch Total annual secondary healthcare costs CD: €3202 vs €3898 ($C5079 vs $C6183) UC/IBDU: €2648 vs €2763 ($C4200 vs $C4382) |
Drug costs Costs related to the secondary healthcare provider (intervention, ward, ambulatory visits, laboratory, radiology, pathology, outpatient visits) |
| CD, UC, IBDU | Razanskaite [44] | Journal Article | Infliximab | 143 | Hospital data | Yes |
Savings to hospital of £40,000–£60,000/month ($C72950–$C109425) |
NR | NA |
| LCD, FCD, UC, IBDU | Ratnakumaran [61] | Journal Article | Infliximab | 191 | Trust data | NS | NR | Savings: £1 million/year ($C1.77 million) | NR |
| NS | Gervais [62] | Journal Article | Infliximab | 33 | Medical records, case reports | NS | Savings: £1500/patient/year ($C2660) | NR | NA |
| Rheumatology | |||||||||
| RA | Dyball [63] | Abstract | Etanercept | 38 | Hospital data | NS | NR |
Savings: £26,400/year ($C48,147) |
NR |
| RA | Peral [37] | Abstract | Etanercept | NR | Survey and Registry | NS | NR |
Switcher vs non-switcher annual costsa €11,478.90 ($C17,801) vs €10,251.14 ($C15,897) |
Drug costs Monitoring Hospitalization Other healthcare costs (no specified) |
| RA | Shah [43] | Abstract | Etanercept | 151 | Clinic data | Yes |
Savings: £500,000/year ($C886,788) |
NR | NA |
| RA | Tarallo [32] | Journal Article | Etanercept | 1259 | Survey | NS |
Annual drug costs per patient: SB4: £8528 ($C14,836) GP2015: £8365 ($C14,552) Originator: £9295 ($C16,170) |
Switcher vs non-switcher annual HCRU costs per patient: Originator to GP2015: + £1120 ($C1948) Originator to SB4: + £1283 ($C2232) |
HCRU cost inputs: Specialist visit (rheumatologist, physiotherapist, occupational therapist, and podiatrist) Rheumatology nurse visit Imaging (X-rays, ultrasounds) Blood tests Hospitalization Emergency visits |
| RA | Nisar [64] | Abstract | Rituximab | 40 | Hospital data | NS | NR |
Savings: approx. £140,000/year ($C240,415) |
NR |
| RA, PsA, AS | Alkoky [71] | Abstract | Etanercept | 158 | Center data | NS | NR |
Savings: approx. £370,000/year ($C656,223) |
NR |
| RA, PsA, AS | Barnes [40] | Abstract | Etanercept | 149–180 center (4 centers) | Center data | Yes | NR |
Switch programme costs: Staff time: £12,638–£16,679 ($C22,414–$C29,581) Implementation: £1615–£30,033 ($C2864–$C53,266) Follow-up costs: £4686–£31,352 ($C8311–$C55,605) |
Switch implementation and follow-up activities: Routine outpatient clinics Time spent auditing and reporting about switch Post-switch clinic appointments |
| RA, PsA, AS | Chan [41] | Journal Article | Etanercept | 113 | Hospital data | Yes |
Savings: £95,017/8 months ($C173,287) |
Overall savings in prescribing costs: £186,000 using switch programme ($C339,217) |
Drug costs Implementation costs Pharmacist costs Administration costs |
| RA, PsA, AS | Dayer [87] | Abstract | Etanercept | 31 | Hospital data | NS |
Annual savings: €3047.72/patient ($C4630) |
NR | NA |
| RA, PsA, AS | Ma [65] | Abstract | Etanercept | 160 | Hospital data, medical records | NS | NR |
Savings: £660, 000/year ($C1,170,561) |
NR |
| RA, PsA, AS | Nascimento Junior [66] | Abstract | Infliximab | 78 | NR | NS |
Savings: R$1.75 million/ 1689 vials ($C0.63 million/1689 vials) |
NR | NA |
| RA, PsA, AS, JIA | Nisar [42, 67] | Abstract | Etanercept | 82 | Hospital data | Yes | NR |
Savings: approx. £100,000/year ($C171,725) |
NR |
| RA, PsA, SpA | Valido [67] | Abstract | Infliximab | 60 | Center data | NS | NR | 26.4% cost reduction | NR |
| NS | Moron [88] | Abstract | Etanercept | 30b | Hospital data | NS |
Savings: €44,713.37/9 months ($C67,922) |
NR | NA |
| NS | Sheppard [73] | Abstract | Infliximab | 25 | Hospital data | NS | NR |
Savings: £70,000/year ($C140,513) |
NR |
| Growth development | |||||||||
| GHD, TS, CRI, PWS, children born small for gestational age | Flodmark [7] | Journal Article | Somatropin | 98 | Hospital data | NS |
Savings: €650,000/year ($C975,480) |
NR | NA |
| Unspecified or multiple disease areas | |||||||||
| NS (areas include rheumatology, gastroentology, internal medicine) | Gutermann [70] | Abstract | Infliximab | 267 | Hospital data | NS | NR |
Savings: €599,540/10 months ($C950,942) |
NR |
| CD, UC, RA, AS | Ramos Rodriguez [74] | Abstract | Infliximab | 48 | Medical records | NS |
Savings: €72,237 (33%) ($C112,025) |
NR | NA |
| NS (RA, AS most common) | Phillips [36] | Abstract | Infliximab | 136 | National database | NS |
Pharmacy costs: TL 1473 vs TL 1329 ($C590 vs $C533) |
Switchers vs non-switchers Outpatient costs: TL 269 vs TL 181 ($C108 vs $C73) Inpatient costs: TL 64 vs TL 29 ($C26 vs $C12) Total healthcare costs: TL 2009 vs TL 1640 ($C805 vs $C657) |
Outpatient costs Inpatient costs Pharmacy costs |
AS axial spondylarthritis, CD Crohn's disease, CRI chronic renal insufficiency, FCD fistulizing Crohn’s disease, GHD growth hormone deficiency, HCRU healthcare resource utilization; IBD inflammatory bowel disease, IBDU inflammatory bowel disease unclassified, JIA juvenile idiopathic arthritis, LCD luminal Crohn’s disease, NMS non-medical switch, NR not reported, NS not specified, PsA psoriatic arthritis, PWS Prader–Willi Syndrome, R Brazilian Real, RA rheumatoid arthritis, SpA spondylarthritis, TL Turkish lira, TS Turner Syndrome, UC ulcerative colitis: $C 2020 Canadian dollars
aAnnual cost-per-patient was estimated using the patient journey scenario of the decision tree model for which inputs were based on survey and registry data
bThe selected cohort of 30 patients included all patients treated with etanercept biosimilar since its incorporation into the pharmacotherapeutic guide of the hospital. The number of patients switched from the reference biologic is not specified