AB0416 Estimating the short-term costs associated with non-medical switching in rheumatic diseases
Authors: A. Gibofsky, V. Garg, M. Yang, C.Z. Qi, M. Skup
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> As biosimilars are approved and commercialised for rheumatic diseases, patients may be switched from originator biologic treatment to biosimilars due to perceived cost savings between the two biologic products. However, in the short term, non-medical switching (NMS) may require additional patient education, office visits, lab/imaging tests, and administrative support which could lead to substantial costs. <h3>Objectives</h3> To estimate the short-term costs associated with NMS from originator biologics to biosimilars among stable patients with rheumatic conditions (e.g., rheumatoid arthritis, RA; ankylosing spondylitis, AS; psoriatic arthritis – PsA) from the perspective of a rheumatology medical centre in the United Kingdom. <h3>Methods</h3> An economic model was constructed including two components: the administrative burden for NMS program set-up and support, and the provider burden for initiating and managing NMS. Administrative burden was modelled at the center-level and considered staff time for program set-up, patient education, scheduling, documentation, and departmental meetings from pre-NMS planning to post NMS implementation (&lt;1 year). The provider burden was modelled at the patient-level and considered the expected additional provider time needed and extra laboratory/imaging tests when managing NMS from the time of switching until 3 month post NMS implementation. Model inputs for the administrative burden came from the literature<sup>1</sup> and for provider burden from survey of physicians. Literature was used to inform both the total number of rheumatology patients that underwent NMS, and the unit cost associated with provider/staff time and laboratory/imaging tests. <h3>Results</h3> From a rheumatology centre perspective, setting up an NMS program and the subsequent administrative support was estimated to cost £19 617 per centre, attributed to general overhead (40%), pharmacist time (26%), consultant time (21%), and nurse time (13%). After the set-up, provider burden for initiating and managing NMS was estimated to be £113 per switched patient. Assuming 5000 patients with relevant rheumatoid conditions in a centre, 572 stable patients with RA, PsA or AS were estimated to switch to biosimilars. The overall short-term cost associated with NMS was estimated to be £84 174 for the entire centre, with 23% attributed to the NMS program set-up and support, and 77% attributed to extra provider time and monitoring (on average £147 cost per switched patient). <h3>Conclusions</h3> Switching stable patients with a rheumatic condition from originator biologics to biosimilars could have considerable short-term costs for a centre. Additional real world studies are needed to better weigh the potential saving vs. cost associated with NMS. <h3>Reference</h3> [1] Barnes T, et al. ISPOR 20th Annual European CongressNovember 4–82017. Glasgow, Scotland. <h3>Acknowledgements</h3> Medical writing support was provided by Cinzia Metallo of Analysis Group; this support was funded by AbbVie. <h3>Disclosure of Interest</h3> A. Gibofsky Shareholder of: AbbVie, Amgen, BMS, GSK, Horizon, J and J and Pfizer, Consultant for: AbbVie, Amgen, Celgene, Eli Lilly and Company, Genentech, Horizon, Iroko, Merck, Novartis, Pfizer, Sandoz and UCB, V. Garg Shareholder of: AbbVie, Employee of: AbbVie, M. Yang Employee of: Analysis Group, Inc., which has received consultancy fees from AbbVie, C. Qi Employee of: Analysis Group, Inc., which has received consultancy fees from AbbVie, M. Skup Shareholder of: AbbVie, Employee of: AbbVie