SAT0209 A comparative real-world utilization patterns of innovator and biosimilar infliximab in a treatment naÏve and switch population from germany: a prescription claims analysis
Authors: E. M. Ewara, L. Ellis, K. Goyal, V. Jairath, A. M. Marrache, X. Baraliakos
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background:</h3> Data on treatment utilization patterns for innovator infliximab (IFX) and biosimilar infliximab (CT-P13) in IBD are scarce. Given low uptake of biosimilars in Canada to date, evaluation of treatment initiation and discontinuation was undertaken in a proxy country, Germany, which has similar demographic factors and neither have a mandated biosimilar switch policy. <h3>Objectives:</h3> Retrospective prescription claims analysis comparing utilization patterns of innovator (IFX) and biosimilar (CT-P13) infliximab in treatment naïve population at 12 months and in patients continuing IFX vs switching to CT-P13 at 6 months. <h3>Methods:</h3> QuintilesIMS™ longitudinal health insurance prescription data from Germany identified patients with an index claim of IFX or CT-P13 in all indications between Feb 2015-Oct 2016. Twelve-month post-drug initiation and 6-month post innovator-to-biosimilar switch retention analyses were conducted. All patients had sufficient claims history post-index and ≥2 claims of IFX or CT-P13 within the analysis period. Six-month analyses included: 1) matched analysis where each CT-P13 switch patient was matched to 5 IFX patients for IFX exposure prior to switch; 2) unmatched analysis where CT-P13 switch patients were compared to the first 6 months of the IFX treatment naïve population. Log-binomial regression analyses were conducted to determine the relative risk (RR) of being retained on treatment at 6 or 12 months adjusted for age, sex, biologic treatment history and prescriber specialty. <h3>Results:</h3> 6,491 patients had a claim of IFX or CT-P13. Of these, 1,160 and 1,324 patients had follow up time for inclusion in the 12-month naïve and 6-month post-switch analyses, respectively. Only IFX to CT-P13 switch utilization (n=101) was investigated. The risk adjusted probability of being retained on treatment after 12 months was 23% greater in the IFX group than in the CT-P13 group (RR IFX=1.23, 95% Confidence Interval [CI]: 1.12–1.36, p&lt;0.0001). The probability of being retained was also greater in men, those who were bio-naive and those prescribed drug by a rheumatologist. In the matched 6 months post-switch analysis the risk adjusted probability of being retained on treatment was 26% greater in the IFX maintenance group than in the CT-P13 switch group (RR IFX=1.26, 95%CI: 1.10–1.45, p=0.0007). The probability of being retained was also greater in those prescribed drug by a rheumatologist. Similar results were found in the unmatched analysis (RR IFX =1.32, 95%CI: 1.16–1.51, p&lt;0.0001), where the probability of being retained was also greater in men and in those who were bio-naïve. <h3>Conclusions:</h3> The findings from Germany demonstrate significant differences in the real-world utilization patterns of patients treated with IFX or CT-P13 in all labelled indications. Limitations of this study include a heterogenous population, disease severity and reasons for staying on treatment or switching could not be determined. Futrure analyses should capture clinical outcomes to better understand observed utilizatin patterns. <h3>Disclosure of Interest:</h3> E. Ewara Employee of: Janssen, L. Ellis Employee of: Janssen, K. Goyal Employee of: Janssen, V. Jairath Consultant for: Abbvie, Takeda, Shire, Janssen, Ferring, Sandoz, Speakers bureau: Ferring, Takeda, Shire, Janssen, A. M. Marrache Employee of: Janssen, X. Baraliakos: None declared