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Short-term costs associated with non-medical switching in autoimmune conditions
A. Gibofsky1, M. Skup2, M. Yang3, M. Mittal4, D. Macaulay5, A. Ganguli6
- Hospital for Special Surgery-Weill Cornell Medicine, New York, NY, USA. gibofskya@hss.edu
- AbbVie, North Chicago, IL, USA.
- Analysis Group, Inc, Boston, MA, USA.
- AbbVie, North Chicago, IL, USA.
- Analysis Group, Inc, New York, NY, USA.
- AbbVie, North Chicago, IL, USA.
CER11182
2019 Vol.37, N°1
PI 0097, PF 0105
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PMID: 29998841 [PubMed]
Received: 16/02/2018
Accepted : 16/04/2018
In Press: 25/06/2018
Published: 18/01/2019
Abstract
OBJECTIVES:
To estimate short-term costs associated with non-medical switch (NMS) from originator biologics to biosimilars among stable patients with autoimmune conditions in rheumatology, gastroenterology, and dermatology from a US provider’s and third-party payer’s perspective.
METHODS:
An economic model was constructed to estimate switching costs related to physician time and healthcare resource utilisation (HRU) at the initial NMS visit and over 3 months. The proportion of patients with relevant conditions treated with originators and expected NMS rate, physician time, HRU, and payer reimbursement were derived from a physician survey. Switching costs were estimated for a practice of 1,000 patients with relevant conditions by therapeutic area and for an insurance plan with 1 million individuals by therapeutic area and all areas combined. Switching cost drivers were assessed with one-way sensitivity analyses.
RESULTS:
Physicians expected extra 6 minutes for the NMS visit and 22 minutes over 3 months; NMS rates of 14.4%, 15.5%, and 17.7%; and 11.3%, 16.2%, and 33.2% of time not reimbursed for gastroenterology, rheumatology, and dermatology, respectively. The total switching costs for payer’s were $771,460 (for n = 3,609 patients with an NMS rate of 16.6%), mostly due to follow-up visits and additional laboratory tests/procedures. In sensitivity analyses, the NMS rate was the main cost driver. Increasing the NMS rate to 25% and 50% increased payer’s total switching costs to $1.19 and $2.39 million, respectively.
CONCLUSIONS:
Originator-to-biosimilar NMS in stable patients with autoimmune conditions could result in considerable switching costs for both providers and payers.