Comparison of medical costs among patients using adalimumab and infliximab: a retrospective study (COMPAIRS)
Daniel A Sussman1, Nisa Kubiliun, Parvez M Mulani
1University of Miami, Division of Gastroenterology, Miami, Florida 33136, USA. dsussman@med.miami.edu
Insights
Adalimumab (ADA) therapy resulted in lower healthcare costs for Crohn's disease (CD) patients compared to infliximab (IFX). This cost difference was primarily driven by reduced outpatient medical expenses in the ADA group.
Area of Science:
- Gastroenterology
- Health Economics
- Pharmacoeconomics
Background:
- Anti-tumor necrosis factor (TNF) therapies are crucial for Crohn's disease (CD) management.
- Real-world comparative data on the costs and utilization of adalimumab (ADA) and infliximab (IFX) in CD is limited.
- This study addresses the need for comparative real-world evidence on anti-TNF medications in CD.
Purpose of the Study:
- To compare the direct healthcare costs and utilization of ADA versus IFX in patients with CD initiating anti-TNF therapy.
- To identify drivers of cost differences between ADA and IFX in a real-world setting.
Main Methods:
- Retrospective analysis of insurance claims data (MarketScan database) for CD patients initiating ADA or IFX.
- Propensity score matching was used to create comparable ADA and IFX cohorts (n=623 each).
- Primary endpoint: direct healthcare costs within 6 months post-initiation. Secondary endpoints: healthcare utilization patterns.
Main Results:
- Propensity-matched cohorts exhibited similar baseline characteristics.
- Total 6-month healthcare costs were significantly lower for ADA ($18,885) compared to IFX ($24,355), a difference of $5,470 (P < 0.0001).
- CD-related costs were also significantly lower with ADA ($16,454) vs. IFX ($22,316) (P < 0.0001), largely due to reduced outpatient visit costs.
Conclusions:
- Adalimumab (ADA) is associated with lower 6-month healthcare costs compared to infliximab (IFX) in Crohn's disease patients.
- The cost savings with ADA were partly attributed to lower outpatient medical expenditures.
- Findings provide valuable real-world economic insights for anti-TNF treatment decisions in CD.
Background:
Anti-tumor necrosis factor (TNF) medications have similar efficacy in Crohn's disease (CD), but have not been compared in the real world. This study compared health costs and utilization for patients with CD newly initiating anti-TNF therapy with adalimumab (ADA) or infliximab (IFX) by using insurance data.
Methods:
CD patients initiating ADA or IFX therapy were identified from the MarketScan database. ADA and IFX groups were matched using a propensity score. The primary endpoint was direct costs of healthcare for the 6 months following initiation. The secondary endpoints compared healthcare utilization between groups.
Results:
After propensity matching, characteristics were similar between the ADA (n = 623) and IFX (n = 623) groups. During the 6-month interval following anti-TNF initiation, healthcare costs were significantly lower for ADA compared with IFX. Total healthcare cost was $18,885 for ADA and $24,355 for IFX, a difference in cost of $5,470 (P < 0.0001). CD-related costs made up the majority of the costs: $16,454 for ADA and $22,316 for IFX (P < 0.0001). The largest difference in cost was seen in outpatient visits: $2,082 difference between the two groups (P < 0.0001). Both all-cause and CD-related hospitalization decreased for both ADA and IFX groups. Emergency room and hospitalization use in the 6-month follow-up period was not statistically different between groups, although numerically slightly higher in the IFX group.
Conclusions:
Patients with CD using ADA had lower healthcare costs than patients using IFX; this difference was partly driven by outpatient medical costs.
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