米国の大規模な処方箋変更は,バイオシミラーアダリムマブ処方量の増加を誘発するが,維持しない
Eric T Roberts1, Gabriela Schmajuk1,2, Mackenzie Clark1
1University of California San Francisco, San Francisco, CA.
Arthritis care & research
|February 16, 2026
まとめ
メジャーな配方変更は当初,バイオシミラーアダリムマブの処方量を増加させたが,その効果は持続しなかった. ノセボ効果や行政上のハードルのような障壁は,バイオシミラーの採用とコスト削減を制限しています.
科学分野:
- レウマトロジーの病理学
- 薬学経済学 薬学経済学
- 医療サービス 研究 医療サービス
背景:
- CVS Caremarkは2024年に国内商用配方剤を更新し,原発生物学的薬よりもアダリムマブ-アダズを好みました.
- この配方変更は,臨床実務におけるバイオシミラーアダリムマブの採用に影響を与えることを目的とした.
研究 の 目的:
- CVS Caremarkの処方箋の変更が,米国のコミュニティ・リウマトロジーの実践におけるバイオシミラーアダリムマブ (アダリムマブ-アダズおよびその他のバイオシミラー) の処方パターンに与える影響を評価する.
- 処方傾向を分析し,支払者層と新規ユーザー層に分類する.
主な方法:
- RISEレジストリからの電子医療記録データに関する中断されたタイムシリーズ分析を使用しました.
- 2023年1月から2024年9月まで,アダリムマブ-アダズおよびその他のアダリムマブバイオシミラルの月間処方比率を調査した.
- 商業保険とメディケアによる分層分析を行い,新規の患者ユーザーに焦点を当てました.
主要な成果:
- 商業的に保険に入っている患者では,アダリムマブ-アダズ処方箋は,処方箋変更後のほぼ0%から25%以上に急増し,その後12.3%減少しました. 他のバイオシミラー薬の処方箋は,ゆっくりと線形的に成長した.
- 新規使用者は同様のパターンを示した:アダリムマブ-アダズでは24%に上昇し,その後ほぼ14%の減少. 他のバイオシミラー処方箋は月間0.6%増加しました.
- メディケアの患者では,アダリムマブ・アダズと他のバイオシミラー処方薬の両方が,より小さく,同様のタイミングで増加したが,その後の有意な減少はなかった.
結論:
- 処方箋の変更に伴い,バイオシミラーアダリムマブ処方箋の急激な増加にもかかわらず,利益は持続しませんでした.
- ノセボ効果や薬剤の変更に伴う管理上の負担を含む,持続的な障壁は,バイオシミラーのより広範な採用を妨げています.
- これらの課題は,米国保健医療市場におけるアダリムマブ治療の潜在的なコスト削減を制限しています.
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