Background Rheumatic diseases generate considerable consumption of health resources due to the use of biological therapies, continuous monitoring of disease and disability. Biological therapies have proven to be effective in disease control compared with standard therapy, but there are differences between them both in safety and cost. Hence the development of protocols that aim at implementing cost effectiveness criteria are required, and providing individualised choice of biological therapy.
Purpose Our goal was the assessment of the evolution of costs in biological intravenous therapy, with respect to treatment and care burden.
Material and methods An observational, descriptive, retrospective study of costs obtained in biological intravenous therapy over 5 years (2011–2015) was conducted. Each year we obtained total treatment costs, costs per pathology (rheumatoid arthritis (RA), psoriatic arthritis (PsA), ankylosing spondylitis (AS), psoriasis (PS), juvenile idiopathic arthritis (JIA) and Behcet’s disease (BD)) and cost of drugs (infliximab (INF), abatacept (ABA), tocilizumab (TOC) and rituximab (RIT)). For assessment of the evolution of the costs and burden of care, the incremental cost and increased number of patients were calculated.
Results There was an overall incremental cost of €−14,719.26. The diagnoses that contributed to savings were: RA with €−211 810.42, PsA €−63 418.96, PS €−28 582.42 and BD €−21 040.86. Pathologies that increased spending were: EA €150 884.53 and JIA €37 317.57. The drug that contributed to the most savings was INF, in RA (€−294 472.77), in PsA (€−66 691.76) and in PS (€−33 413, 62). Regarding drug spending, INF contributed the most, in AS (€159 884.53), and TOC in JIA (€38 358.68). The incremental number of patients was 4.
Conclusion In this study, we observed considerable savings in the cost of treatments, due to drugs, probably due to falling prices and dose adjustment intervals according to the patient’s clinical status. The appearance on the market of biosimilars has not changed early treatment with INF in our hospital, so the cost can still improve in this area. Further studies will be needed to assess the inclusion of the majority of biosimilars as treatment of disease in both early treatment and treatment changes.
No conflict of interest
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