SAT0747-HPR The impact of non-persistence on the direct and indirect costs in patients treated with subcutaneous tumour necrosis factor-alpha inhibitors in germany. (12th June 2018)

• Record Type: Journal Article
• Authors: Ziegelbauer, K.; Hübinger, M.; Dombrowski, S.; Kostev, K.; Friedrichs, M.; Friedel, H.; Kachroo, S.
• Is Part Of: Annals of the rheumatic diseases. Volume 77(2018)Supplement 2
• Page Start: 1834
• Page End: 1834
• Publication Date: 2018-06-12
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2018-eular.1453
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: No recent data is available about the association between non-persistence with subcutaneous TNFi and costs in Germany. Objectives: The goal of the present study was to estimate the direct and indirect treatment costs in immune-mediated rheumatic disease (IMRD) patients initiating treatment with a subcutaneous biologic agent based on treatment persistence. Methods: This is a retrospective cohort study based on the German statutory health insurance funds database. Patients aged ≥18 with a diagnosis of ankylosing spondylitis, psoriatic arthritis, or rheumatoid arthritis treated with subcutaneous TNF-alpha blockers (sc-TNFis) were included. Persistence was estimated as the duration of time from sc-TNFis therapy initiation to discontinuation, which was defined as at least 60 days without therapy. We performed 1:1 matching based on a propensity score that was constructed as the conditional probability of being persistent as a function of age, gender, index year, physician specialty, and Charlson comorbidity index. Finally, the differences in direct costs, indirect costs, and services between the matched pairs were estimated using the Wilcoxon test. Results: After 1:1 matching, 678 persistent and 678 non-persistent patients were available for cost analyses. Both cohorts were similar in terms of age, gender, year of therapy initiation, CCI, and indication. Using a two-year time period, the costs for office based visits per patient were €2319 in the persistent cohort, as compared to €3094 in the non-persistent cohort (p<0.001). Co-medication costs were €2828 in the persistent cohort, as compared to €5498 in the non-persistent cohort (p<0.001), hospitalisation costs were €3551 in persistent cohort, as compared to €5890 in non-persistent patients, and sick leave costs were €717 in persistent cohort, as compared to €1241 in non-persistent patients. Conclusions: The results of this study indicate that persistence with SC-TNFis treatment can be associated with several cost offsets for IMRD patients. For healthcare providers/payers, these findings reinforce the value of persistence, given the additional economic burden associated with non-persistent patients. Disclosure of Interest: K. Ziegelbauer: None declared, M. Hübinger: None declared, S. Dombrowski: None declared, K. Kostev: None declared, M. Friedrichs: None declared, H. Friedel: None declared, S. Kachroo Employee of: Merch and Co