Study Examines Costs of Oral vs Injectable Immunotherapies

A study at the AMCP 2018 Annual Meeting compared health care utilization, medication switching, and costs among patients taking oral immunotherapies and injectable immunotherapies.

“Rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and psoriasis are a group of immune-mediated systemic, chronic inflammatory conditions,” Rituparna Bhattacharya, PhD, MS, research scientist at Comprehensive Health Insights at Humana, and colleagues wrote in their poster presentation. “Moderate to severe disease may require treatment with biologic immunotherapy administered via infusion, injection, or orally. Although effectiveness of established infusibles and injectables and newer orals is known, the relative effectiveness among routes of administration, is not well understood.”

Dr Bhattacharya and colleagues conducted a retrospective observational study in order to compare health care utilization and costs based on route of administration for immunotherapies. 

The study included claims data from a large US health plan for patients taking immunotherapies with joint conditions, skin conditions, and a combination of joint and skin conditions. Claims data included Medicaid, Medicare Advantage, and private health insurance patients. The oral immunotherapies cohort included 466 patients with joint conditions, 269 patients with skin conditions, and 173 patients with both conditions. Likewise, the injectable cohort included 4236 patients with joint conditions, 980 patients with skin conditions, and 855 patients with both conditions. 

Study results showed that patients on oral therapies switched medications more frequently. Additionally, the study found that health resource utilization, both inpatients and outpatient, were higher in the oral therapies group. However, total costs were lower, at about $45,000 vs approximately $55,000. Biologic costs were also lower among oral therapy users, at approximately $30,000 vs $37,879 to $45,187, for injectables across all condition types.

“This is the first population-level study at a route of administration level which compared switching, health resource utilization, and costs...” Dr Bhattacharya and colleagues wrote. “Switching was more likely in the oral group, health resource utilization was higher in the oral group, but total costs in the oral group were lower, likely driven by the lower costs of the oral biologics.”

—David Costill