Patient-reported outcome assessment of inflammatory arthritis patient experience with intravenously administered biologic therapy

Norman B Gaylis,1 Joanne Sagliani,1 Shawn Black,2 Kezhen L Tang,3 Raphael DeHoratius,2,4 Wesley A Kafka,2 Dennis Parenti2 1Arthritis & Rheumatic Disease Specialties, Aventura, FL, USA; 2Medical Affairs Rheumatology, Janssen Scientific Affairs, LLC, Horsham, PA, USA; 3Quantitative Sciences, Janssen Research & Development, LLC, Spring House, PA, USA; 4Department of Medicine and Pharmacology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA Objective: To evaluate patient perspectives regarding utilization of intravenous (IV) therapy for inflammatory arthritis (IA).Methods: This was a single-center, noninterventional, patient questionnaire-based study of adult IA patients currently receiving IV biologics. At a single visit, patients completed the questionnaire comprising 30 questions centered on their experience receiving an intravenously administered therapy to treat their IA. The questionnaire included questions on patient demographics, disease characteristics, and previous biologic treatment for IA (subcutaneous [SC] and IV). Patients rated their level of agreement with statements regarding satisfaction with current IV biologic therapy and potential advantages and disadvantages of IV biologic therapy using a 5-point Likert scale (1= strongly disagree, 5= strongly agree).Results: One hundred patients were enrolled and completed the survey; 66% were female and the mean age was 58 years. Before IV treatment, 97% of patients received information regarding therapy options. Ninety patients ranked their satisfaction with current IV therapy as 4 or 5. The proportion of patients with an “extremely favorable” perception of IV therapy increased from 33% to 71% following initiation of their current medication. Thirty-one patients had previously received SC therapies to treat their IA.Conclusion: These results demonstrated an overall favorable perception of IV therapy among this patient population. Patients previously treated with SC therapy also had a positive shift in the perception of IV therapy after initiating IV therapy. Patients’ perception and preference for treatment options should be highly considered by the treating physician during or as part of a shared decision-making process. Keywords: intravenous, patient satisfaction, arthritis, biologic therap

Comparative analysis of US real-world dosing patterns and direct infusion-related costs for matched cohorts of rheumatoid arthritis patients treated with infliximab or intravenous golimumab

Lorie A Ellis,1 Elisabetta Malangone-Monaco,2 Helen Varker,3 Diana Stetsovsky,3 Maureen Kubacki,1 Raphael J DeHoratius,1,4 Shelly Kafka1 1Real World Value and Evidence, Janssen Scientific Affairs, LLC, Horsham, PA, USA; 2Life Sciences, IBM Watson Health, Armonk, NY, USA; 3Life Sciences, IBM Watson Health, Cambridge, MA, USA; 4Janssen Immunology, Medical Affairs, Sidney Kimmel School of Medicine, Thomas Jefferson University, Philadelphia, PA, USA Purpose: The objectives of this study were to evaluate and compare treatment patterns and infusion-related health care resource expenditures for rheumatoid arthritis (RA) patients initiating golimumab for intravenous use (GLM-IV) and infliximab (IFX) therapy and to assess cost implications from the commercial perspective.Methods: Adult RA patients with a new episode of GLM-IV or IFX treatment between January 1, 2014 and March 31, 2016 were identified from MarketScan databases and evaluated for maintenance infusion intervals and related costs of treatment. IFX and GLM-IV patients were matched 1:1 on index medication treatment duration, gender, payer type, prior biologic use, and post-index methotrexate use. Paid amounts for drugs and associated administration costs were applied to treatment group dosing patterns.Results: Final matched treatment groups included 547 GLM-IV and 547 IFX patients (mean age = 55–56 years). Mean (SD) follow-up was 609 (161) days for GLM-IV and 613 (163) days for IFX. Treatment duration was 396 (240) days for GLM-IV and 397 (239) days for IFX. Overall, 80% of GLM-IV and 39% of IFX maintenance infusions were given approximately every 8 weeks; and 6% of GLM-IV and 53% of IFX maintenance infusions occurred more frequently than every 8 weeks (P<0.001). When weighting of the maintenance infusion interval was applied, the mean number of induction plus maintenance infusions during the first year of treatment was estimated at 7.03 for GLM-IV and 9.48 for IFX. From the commercial perspective, drug plus administration costs per infusion were $5,846 for GLM-IV and$5,444 for IFX with total annual cost of therapy for GLM-IV patients costing $10,507 less than that for IFX patients in the first year and$6,774 less than that for IFX patients in subsequent years.Conclusion: Annual GLM-IV drug plus administration costs for commercial health plans were significantly less than IFX in RA patients due to differences in real-world dosing and administration. Keywords: rheumatoid arthritis, infliximab, golimumab, dosing, treatment pattern