AB1163 IMPACT ON COSTS AND WORKING LIFE OF RHEUMATIC PATIENTS WITH CHANGE IN BIOLOGICAL THERAPY FOR NO MEDICAL REASONS. REAL LIFE EXPERIENCE IN REGIONAL HOSPITAL OF SOCIAL SECURITY
Authors: L. Pablo Olivares, E. González Figueroa, M. F. López Marquet, M. V. Goycochea Robles
Journal: Annals of the Rheumatic Diseases (2020)

Background: Biologics as new therapeutic alternatives have revolutionized the management of rheumatic diseases. Biosimilars have been emerged as less expensive alternative. Most part of evaluations of biosimilars had proved effectiveness by clinical trials with outcomes as remission, but specific social aspects and economic variables not always has been considered. These aspects must be assessed in specific and real contexts (countries, health institutions) The effect on non-medical switch of biological therapy for rheumatic diseases in costs and working variables has not been documented in patients of the Mexican Social Security Institute (IMSS) Objectives: Evaluate the impact of the change of biological therapy for non-medical reasons on the economic variables, costs and working aspects with rheumatic diseases on Mexican patients with social security Methods: Cross-sectional observational study included patients from rheumatology clinical service of an IMSS Regional Hospital in Mexico City during last trimester of 2018. A structured questionnaire was applied who diagnosis of rheumatoid arthritis and spondyloarthropathies where received treatment biological for at least 24 months prior to the study. The individuals were divided into two comparison groups, G1: patients who changed to biosimilar biological treatment for non-medical reasons and G2: patients with original biological treatment without changes in the therapeutic scheme. In addition to socio-demographic characteristics, functional capacity (HAQ-di), disease activity (DAS28) and labor aspects were evaluated. A sex and age adjusted logistic regression analysis was performed where the outcome variable was the evolution Results: The 71 cases evaluated included 90% female with schooling &gt; 9 years in 90%. GI included 49%, age 51.1 years ± 15.1 vs G2 55.8 + 12.7; evolution in years: GI: 13.8 + 4.7 vs GII: 9.74 + 5.97. Both groups persisted in remission by DAS28 (G1:2.50 + 0.489 VS G2: 2.39 + 0.63). The G1 had a higher percentage of moderate affection in functional capacity: 58.8% vs G2: 35.9%, required more travel time to work, 2 hours less work per day and required more disability (48% vs 43% [RM0 1.6 95% CI: 0.45-3.4] After logistic regression models adjusted by age and sex, no significant results were found for economic and costs variables. However, a statistically significant association (p=0.017) were found for time progression disease as predictor variable between G1 Vs Group 2 (OR=1.15, 95% CI 1.02, 1.30). Mean time progression disease for G1 were 9.38±6.5 years (n=43) and for G2 were 14.17±5.5 years (n=28) Conclusion: IMSS rheumatic patients who were on their original biological treatment, had more working time and improved statistically significative their time progression disease. Switch to biosimilar not have impact in clinical remission but can impact in economic and working aspects. IMSS serves 50% of Mexican population, covering medical care (physician fees, laboratory and medication purchase), and social security; so, should consider not only clinical aspects to acquisition of biologics drugs Acknowledgments: FUNDACION IMSS Disclosure of Interests: None declared