THU0653 SOCIOECONOMIC ANALYSIS OF GOLIMUMAB TREATMENT IN PATIENTS WITH RA, PSA, AND AS – NON-INTERVENTIONAL STUDY GO-NICE
Authors: Klaus Krueger, Gerd Rüdiger Burmester, Siegfried Wassenberg, Astrid Thiele, Matthias Thomas
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Rheumatic diseases are associated with pain, loss of functionality, fatigue, hospitalization, sick leave, and work disability. This results in high economic burden for patients and society. <h3>Objectives:</h3> Golimumab (GLM) is an effective but costly treatment option for patients (pts.) with moderate to severe, active rheumatic diseases. The aim of this analysis of the GO-NICE study was to investigate the direct and indirect costs of healthcare utilization and sick leave after starting a treatment with GLM. <h3>Methods:</h3> Data of outpatients collected in the non-observational study GO-NICE in 1,483 pts. with RA (n = 474), PsA (n=501), and AS (n=483) in 158 sites (2010-2015) in Germany were analysed. Details on the study design, pts. characteristics, the clinical and patient-reported outcomes, and safety data have been reported earlier [1,2]. Direct medical and indirect costs per patient and year were calculated for consultations, physiotherapy, massages, hospitalisations and inpatient rehabilitation, medication (DMARDs, Glucocorticoids, NSAIDs, and biologics) as well as sick leave days. Findings were shown for RA-, PsA- and AS-pts. and categorised by biological-naïve pts. and pts. with a pre-treatment with a biologic. The 6-month periods prior baseline (BL)/start of a GLM therapy vs. month 24 (M24) were compared. For this calculation the standardized evaluation rates were used (Bock et al. (2015), AG MEG of the DGSMP (2005). Costs for prescribed and documented medication were calculated by the mean cost per defined daily dose (based 2010-2015). Indirect costs were estimated through the human capital approach (HCA). <h3>Results:</h3> Data of 758 biologic-naïve pts. (n = 265 RA, 247 PsA and 246 AS) and 694 pts. with biologics as pre-therapy (n = 208 RA, 252 PsA and 234 AS) were included in the analysis. Direct medical costs (excl. medication) decreased in all 6 groups, min. 765€ (PsA pre-treatment group) and max. 2,426€ (AS pre-treatment) as well as the costs due to work disability/absenteeism, min. 855€ (PsA pre-treatment) and max. 2.564€ (RA pre-treatment, table). Total costs in biological-naïve pts. increased due to the additional expense of the biologic agent. Absolute changes in costs totalled 15,665€ (RA-, table), 15,799€ (PsA-) and 14,764€ (AS-patients) per patient and year when comparing the BL vs. M24 periods. Total savings of 6,289€ (RA-, table), 2,617€ (PsA-), and 5,555€ (AS-patients) per patient and year were generated in the group of biologic-pre-treated patients. <h3>Conclusion:</h3> Costs of healthcare utilization, as well as work disability decreased after starting GLM within an observation period of 24 months, for pts. with RA, PsA, and AS, respectively. Due to the high costs of TNFi therapy, drug costs in the group of biologic-naive pts. rose markedly. Savings were generated in the group of pts. pre-treated with biologics. <h3>References:</h3> [1] K. Krüger, et al. BMJ Open 2018 [2] K. Krüger, et al. Rheumatology International 39 (1) 2019 <h3>Acknowledgement:</h3> Health Economics Research Zentrum, Burgdorf, Germany <h3>Disclosure of Interests:</h3> Klaus Krueger: None declared, Gerd Rüdiger Burmester Consultant for: Roche, Sanofi-Genzyme, Speakers bureau: Roche, Sanofi-Genzyme, Siegfried Wassenberg Grant/research support from: Roche Pharma, Consultant for: Abbvie, BMS, Chugai, Roche, Novartis, Pfizer, MSD, Speakers bureau: Abbvie, BMS, Pfizer, Janssen, Chugai, Celgene, Roche, Novartis, MSD, Astrid Thiele Consultant for: Biogen, Celgene, Chugai, Hexal, Janssen, Lilly, MSD, Novartis, Pfizer, UCB, Matthias Thomas Employee of: MSD Sharp &amp; Dohme GmbH Germany