Market share and costs of biologic therapies for inflammatory bowel disease in the USA

Published on Feb 1, 2018in Alimentary Pharmacology & Therapeutics7.515
· DOI :10.1111/APT.14430
Helen Yu6
Estimated H-index: 6
(Stanford University),
Donna MacIsaac6
Estimated H-index: 6
(Stanford University)
+ 5 AuthorsK.T. Park19
Estimated H-index: 19
(Stanford University)
Sources
Abstract
SummaryBackground Real-world data quantifying the costs of increasing use of biologics in inflammatory bowel disease (IBD) are unknown. Aim To determine the outpatient IBD drug utilization trends, relative market share, and costs in the USA during a 9-year period. Methods The Truven MarketScan® Database was analysed for patients with Crohn's disease (CD) and ulcerative colitis (UC) during 2007-2015. National drug codes were used to identify prescription drugs; Healthcare Common Procedure Coding System J-codes were used to capture biologic out-patient infusions. Proportion of drug usage, relative market share and per-member per-year (PMPY) costs were analysed for biologics, immunomodulators, 5-ASAs and corticosteroids. Results In 415 405 patients (188 842 CD; 195 183 UC; 31 380 indeterminate colitis; 54.67% female), utilization trends show a consistent rise in the market share of biologics during the 9-year study period. The proportion of patients using biologics increased from 21.8% to 43.8% for CD and 5.1%-16.2% for UC. This contrasts a small decrease in immunomodulator and 5-ASA use for CD and relative constancy of other classes including corticosteroids-only use as primary IBD medication from 2007 to 2015. The average biologic-taking patient accounted for 25 275 PMPY in 2007 and 6 051 PMPY in 2015. The average paediatric biologic-taking patient accounted for 23 616 PMPY in 2007 and 1 109 PMPY in 2015. In all patients, the share of costs for biologics increased from 72.9% in 2007 to 85.7% in 2015 (81.7% in 2007 to 94.9% in 2015 in paediatrics). Conclusion The vast majority of costs allocated to out-patient IBD medications in the USA is attributed to increasing use of biologic therapies despite the relative minority of biologic-taking patients.
Figures & Tables
Download
📖 Papers frequently viewed together
201760.39The Lancet
12 Authors (Siew C. Ng, ..., Gilaad G. Kaplan)
1,504 Citations
99 Citations
56 Citations
References22
Newest
SummaryBackground Management of inflammatory bowel disease (IBD) has evolved in the last decade. Aim To assess IBD therapeutic management, including treatment withdrawal and early treatment use in the current era of anti-TNF agents (anti-TNFs). Methods All patients affiliated to the French national health insurance diagnosed with IBD were included from 2009 to 2013 and followed up until 31 December 2014. Medication uses, treatment sequences after introduction of thiopurine or anti-TNF monotherap...
49 CitationsSource
Infliximab “biosimilars”—biological therapies engineered to work in the same way as the monoclonal antibody drug infliximab (marketed as Remicade)—are safe and effective and could halve the cost of inflammatory bowel disease (IBD) treatment, a report by the Royal College of Physicians has found.1 Use of these drugs could cut the cost of an annual course of treatment from around £10 000 (€11 700: $13 000) to around £5000, the authors said. Given their reduced cost, clinicians should use biosimila...
2 CitationsSource
#1Aaron S. Kesselheim (Brigham and Women's Hospital)H-Index: 63
#2Jerry Avorn (Brigham and Women's Hospital)H-Index: 142
Last. Ameet Sarpatwari (Brigham and Women's Hospital)H-Index: 17
view all 3 authors...
Importance The increasing cost of prescription drugs in the United States has become a source of concern for patients, prescribers, payers, and policy makers. Objectives To review the origins and effects of high drug prices in the US market and to consider policy options that could contain the cost of prescription drugs. Evidence We reviewed the peer-reviewed medical and health policy literature from January 2005 to July 2016 for articles addressing the sources of drug prices in the United State...
298 CitationsSource
#1Mirthe E. van der Valk (University Medical Center Utrecht)H-Index: 9
Last. ColitisH-Index: 9
view all 22 authors...
textabstractBackground: With the increasing use of anti-TNF therapy in inflammatory bowel disease (IBD), a shift of costs has been observed with medication costs replacing hospitalization and surgery as major cost driver. We aimed to explore the evolution of IBD-related costs over two years of follow-up. Methods and Findings: In total 1,307 Crohn's disease (CD) patients and 915 ulcerative colitis (UC) patients were prospectively followed for two years by three-monthly web-based questionnaires. C...
70 CitationsSource
#1K.T. Park (Stanford University)H-Index: 19
#2Richard B. Colletti (UVM: University of Vermont)H-Index: 42
Last. Andrew KruegerH-Index: 8
view all 6 authors...
Health Insurance Paid Costs and Drivers of Costs for Patients With Crohn’s Disease in the United States
56 CitationsSource
#1Christopher B. Forrest (Children's Hospital of Philadelphia)H-Index: 66
#2Peter A. Margolis (Cincinnati Children's Hospital Medical Center)H-Index: 41
Last. Richard B. Colletti (UVM: University of Vermont)H-Index: 42
view all 4 authors...
Except for a few conditions, pediatric disorders are rare diseases. Because of this, no single institution has enough patients to generate adequate sample sizes to produce generalizable knowledge. Aggregating electronic clinical data from millions of children across many pediatric institutions holds the promise of producing sufficiently large data sets to accelerate knowledge discovery. However, without deliberately embedding these data in a pediatric learning health system (defined as a health ...
77 CitationsSource
#1David T. Rubin (U of C: University of Chicago)H-Index: 91
#2Reema Mody (Takeda Pharmaceutical Company)H-Index: 21
Last. Chi-Chuan Wang (RTP: Research Triangle Park)H-Index: 16
view all 4 authors...
SummaryBackground Treatments for Crohn's disease (CD) and ulcerative colitis (UC) are not uniformly effective, thus necessitating dose changes, switching, and augmentation and carry adverse event risk, often requiring discontinuation, which reduces treatment benefits. Aim To assess continuity of and changes to initial CD and UC treatments, as well as costs associated with specific parameters defining suboptimal therapy. Methods Commercial US insurance claims (2006–2010) were retrospectively anal...
42 CitationsSource
#1Mirthe E. van der Valk (University Medical Center Utrecht)H-Index: 9
Last. ColitisH-Index: 9
view all 22 authors...
Objective The introduction of anti tumour necrosis factor-α (anti-TNFα) therapy might impact healthcare expenditures, but there are limited data regarding the costs of inflammatory bowel diseases (IBD) following the introduction of these drugs. We aimed to assess the healthcare costs and productivity losses in a large cohort of IBD patients. Design Crohn's disease (CD) and ulcerative colitis (UC) patients from seven university hospitals and seven general hospitals were invited to fill-out a web-...
338 CitationsSource
BACKGROUND: Inflammatory bowel diseases (IBD) – Crohn’s disease (CD) and ulcerative colitis (UC) – significantly impact quality of life and account for substantial costs to the health care system and society.
208 CitationsSource
#1Candace GunnarssonH-Index: 23
#2Jie Chen (UMD: University of Maryland, College Park)H-Index: 24
Last. Jennifer H. Lofland (Janssen Pharmaceutica)H-Index: 19
view all 5 authors...
Background Crohn’s disease (CD) and ulcerative colitis (UC) are chronic, debilitating conditions that can have important economic and clinical implications.
66 CitationsSource
Cited By82
Newest
#1Prashanthi Kandavel (Boston Children's Hospital)
Last. Jeremy AdlerH-Index: 20
view all 3 authors...
Source
BACKGROUND Knowledge of the cost of illness of inflammatory bowel disease (IBD) is essential for health policy makers worldwide. AIM To assess the cost of illness of IBD from the societal perspective taking into account time trends and geographical differences. METHODS A systematic review of all population-based studies on cost of illness of IBD published in Embase, Medline, Web of Science and Google Scholar. Methodology of included studies was assessed and costs were adjusted to 2018 US dollars...
Source
#1Celine Miyazaki (Janssen Pharmaceutica)H-Index: 1
#2Nagano Katsumasa (Janssen Pharmaceutica)
Last. Yan Fang Liu (Janssen Pharmaceutica)
view all 4 authors...
Biologics are recommended in Japan to treat moderate to severe Crohn's Disease (CD). Although CD is associated with high direct costs in Japan, updated information after ustekinumab's approval is unavailable. We aimed to evaluate the healthcare resource utilization (HRU) and associated direct costs from the payer's perspective in Japan. Claims data (2010-2018) were retrospectively analyzed to identify patients with CD. HRU and associated costs were evaluated for 12 months before and after biolog...
Source
#1Duan LinshanH-Index: 1
Last. Guoyan LiuH-Index: 3
view all 6 authors...
Source
#1Jessica W. Crothers (UVM: University of Vermont)H-Index: 8
#2Nathaniel D. Chu (MIT: Massachusetts Institute of Technology)H-Index: 7
Last. Mario Velez (University of Vermont Medical Center)H-Index: 1
view all 21 authors...
Fecal microbiota transplantation (FMT) is a promising new strategy in the treatment of Inflammatory Bowel Disease, but long-term delivery systems are lacking. This randomized study was designed as a safety and feasibility study of long-term FMT in subjects with mild to moderate UC using frozen, encapsulated oral FMT (cFMT). Subjects were randomized 1:1 to receive FMT induction by colonoscopy, followed by 12 weeks of daily oral administration of frozen encapsulated cFMT or sham therpay. Subjects ...
Source
#1Natsuki Ito (Juntendo University)
#2Ichiro TakeuchiH-Index: 3
Last. Katsuhiro AraiH-Index: 9
view all 9 authors...
Source
#4Moheb Boktor (UTSW: University of Texas Southwestern Medical Center)
#4Moheb Boktor (UTSW: University of Texas Southwestern Medical Center)H-Index: 10
Last. David I. Fudman (UTSW: University of Texas Southwestern Medical Center)H-Index: 2
view all 5 authors...
Source
#1Bart Roman (UGent: Ghent University)H-Index: 14
Over the past decades, therapeutics based on biological macromolecules and cells have successfully entered the clinical arena and progressively occupied an increasing share of what once was almost exclusively small molecule territory. This perspective explores the opportunities for chemists at the interface between biologics and small molecule-based products. It provides concrete examples by zooming in on the area of post-translational protein modification. The conclusion is that, rather than di...
Source
#1Pepijn W. A. Thomas (Radboud University Nijmegen)H-Index: 1
#2Tessa E H Römkens (Bosch)H-Index: 13
Last. Frank Hoentjen (Radboud University Nijmegen)H-Index: 16
view all 8 authors...
BACKGROUND Only limited data is available on the extent and burden of adverse drug reactions (ADRs) to biological therapy in inflammatory bowel disease (IBD) patients in daily practice, especially from a patient's perspective. OBJECTIVE The aim of this study was to systematically assess patient-reported ADRs during biological therapy in IBD patients and compare these with healthcare provider (HCP)-reported ADRs. METHODS This multicentre, prospective, event monitoring study enrolled IBD patients ...
Source
#1R Grant (Western General Hospital)H-Index: 1
Last. Ailsa HartH-Index: 57
view all 12 authors...
AIM We aimed to determine factors associated with poor wound healing in patients with perianal Crohn's disease (pCD) who had undergone proctectomy in the biologics era. METHOD Case record review was performed on 103 patients with pCD who underwent proctectomy at St Mark's Hospital, Harrow and the Western General Hospital, Edinburgh between 2005 and 2017. Healing rates at 6 and 12 months post-proctectomy were considered; univariate analysis was performed. RESULTS Sixty out of 103 patients (58.3%)...
Source