PDF(Pubmed)
Abstract：
BACKGROUND: Biosimilars are biologic drugs that have the potential to increase the efficiency of healthcare spending and curb drug-related cost increases. However, their introduction into hospital formularies through initiatives such as non-medical switching must be carefully orchestrated so as not to cause treatment discontinuation or result in increased health resource utilization, such as additional visits or laboratory tests, among others. This retrospective cohort study aims to assess the impact of the introduction of CT-P13 on the healthcare expenditures of patients who were treated with originator infliximab or CT-P13.
METHODS: Gastroenterology, immunoallergology and rheumatology patients treated between September 2017 and December 2020 at a university hospital in Western Switzerland were included and divided into seven cohorts, based on their treatment pathway (i.e., use and discontinuation of CT-P13 and/or originator infliximab). Costs in Swiss francs were obtained from the hospital\'s cost accounting department and length of stay was extracted from inpatient records. Comparisons of costs and length of stay between cohorts were calculated by bootstrapping.
RESULTS: Sixty immunoallergology, 84 rheumatology and 114 gastroenterology patients were included. Inpatient and outpatient costs averaged (sd) CHF 1,611 (1,020) per hospital day and CHF 4,991 (6,931) per infusion, respectively. The mean (sd) length of stay was 20 (28) days. Although immunoallergology and rheumatology patients had higher average costs than gastroenterology patients, differences in costs and length of stay were not formally explained by treatment pathway. Differences in health resource utilization were marginal.
CONCLUSIONS: The introduction of CT-P13 and the disruption of patient treatment management were not associated with differences in average outpatient and inpatient costs and length of stay, in contrast to the results reported in the rest of the literature. Future research should focus on the cost-effectiveness of non-medical switching policies and the potential benefits for patients.
METHODS: Gastroenterology, immunoallergology and rheumatology patients treated between September 2017 and December 2020 at a university hospital in Western Switzerland were included and divided into seven cohorts, based on their treatment pathway (i.e., use and discontinuation of CT-P13 and/or originator infliximab). Costs in Swiss francs were obtained from the hospital\'s cost accounting department and length of stay was extracted from inpatient records. Comparisons of costs and length of stay between cohorts were calculated by bootstrapping.
RESULTS: Sixty immunoallergology, 84 rheumatology and 114 gastroenterology patients were included. Inpatient and outpatient costs averaged (sd) CHF 1,611 (1,020) per hospital day and CHF 4,991 (6,931) per infusion, respectively. The mean (sd) length of stay was 20 (28) days. Although immunoallergology and rheumatology patients had higher average costs than gastroenterology patients, differences in costs and length of stay were not formally explained by treatment pathway. Differences in health resource utilization were marginal.
CONCLUSIONS: The introduction of CT-P13 and the disruption of patient treatment management were not associated with differences in average outpatient and inpatient costs and length of stay, in contrast to the results reported in the rest of the literature. Future research should focus on the cost-effectiveness of non-medical switching policies and the potential benefits for patients.
摘要：
背景：生物仿制药是生物药物，具有提高医疗支出效率和抑制药物相关成本上涨的潜力。然而,必须精心安排通过非医疗转换等举措将其引入医院处方集，以免导致治疗中断或导致卫生资源利用率提高，例如额外的访问或实验室测试，在其他人中。这项回顾性队列研究旨在评估CT-P13的引入对使用鼻祖英夫利昔单抗或CT-P13治疗的患者的医疗支出的影响。
方法：胃肠病学，纳入了2017年9月至2020年12月在瑞士西部一所大学医院接受治疗的免疫变态反应学和风湿病患者，并分为七个队列，基于他们的治疗途径(即，使用和停用CT-P13和/或原药英夫利昔单抗)。从医院的成本核算部门获得瑞士法郎的费用，并从住院记录中提取住院时间。通过自举计算队列之间的成本和住院时间的比较。
结果：60种免疫变态反应学，包括84例风湿病和114例胃肠病患者。住院和门诊费用平均（sd）每住院日1,611瑞士法郎（1,020），每次输液4,991瑞士法郎（6,931），分别。平均（sd）住院时间为20（28）天。尽管免疫变态反应和风湿病患者的平均费用高于消化内科患者，治疗途径并未正式解释费用和住院时间的差异.卫生资源利用的差异很小。
结论：CT-P13的引入和患者治疗管理的中断与平均门诊和住院费用以及住院时间的差异无关。与其他文献报道的结果相反。未来的研究应集中在非医疗转换政策的成本效益和患者的潜在利益。
方法：胃肠病学，纳入了2017年9月至2020年12月在瑞士西部一所大学医院接受治疗的免疫变态反应学和风湿病患者，并分为七个队列，基于他们的治疗途径(即，使用和停用CT-P13和/或原药英夫利昔单抗)。从医院的成本核算部门获得瑞士法郎的费用，并从住院记录中提取住院时间。通过自举计算队列之间的成本和住院时间的比较。
结果：60种免疫变态反应学，包括84例风湿病和114例胃肠病患者。住院和门诊费用平均（sd）每住院日1,611瑞士法郎（1,020），每次输液4,991瑞士法郎（6,931），分别。平均（sd）住院时间为20（28）天。尽管免疫变态反应和风湿病患者的平均费用高于消化内科患者，治疗途径并未正式解释费用和住院时间的差异.卫生资源利用的差异很小。
结论：CT-P13的引入和患者治疗管理的中断与平均门诊和住院费用以及住院时间的差异无关。与其他文献报道的结果相反。未来的研究应集中在非医疗转换政策的成本效益和患者的潜在利益。
