Background Golimumab (GLM) has recommended dosing of 50 mg once monthly for the treatment of psoriatic arthritis (PsA) in the United States (U.S.). GLM U.S. utilization data, published thus far, have modeled projected costs based on less than one year of data and have not been specific to a population of patients with PsA.
Objectives To calculate expected mean annual GLM U.S. costs based on observed one-year dosing patterns within a managed care population of PsA patients.
Methods The IMS LifeLink™ Health Plan Claims database was utilized to identify patients who had/were: index golimumab pharmacy claim started 4/24/2009-01/06/2010; aged ≥18 years at index; ≥1 PsA ICD-9 diagnosis code (696.0); and 12 months pre- and ≥12 months post-index continuous enrollment. Biologic experience was defined as ≥1 medical or pharmacy claims for abatacept, adalimumab, certolizumab, etanercept, or infliximab at anytime during the 12 month period prior to the first GLM prescription. GLM utilization was reported as the proportion of patients and prescriptions at the recommended 50 mg dose, and intervals between fills, for the 12 month post-index period. Annual costs were modeled in U.S. dollars using the GLM wholesale acquisition cost (effective 7/5/2011) of $1,941.65 per 50 mg.
Results A total of 127 PsA patients receiving GLM (n=914 prescriptions) were identified; 59.8% were female; mean±SD age was 49±10 years. The majority (78.7%) of patients had pre-index biologic experience. Among the biologic-experienced, 73.0% experienced 1 unique biologic, 24.0% experienced 2 unique biologics, and 3.0% experienced 3+ unique biologics at some time point before GLM. A 50 mg GLM dose was dispensed in 95.3% of all PsA patients upon initiation and 96.6% of all prescriptions. The GLM dose at each of the first 12 prescription fills was 50 mg for 95.2%>97.9% of patients. A 50 mg GLM dose was dispensed upon initiation in 94.0% and 100.0% of biologic-experienced and non-biologic-experienced PsA patients, respectively. The overall mean±SD interval between GLM prescriptions was 32±14 days; the median was 30 days. Based upon the observed GLM prescription intervals, a mean of 11.4 GLM doses per year would be realized. The expected mean annual GLM acquisition costs for PsA patients would total $22,135.
Conclusions In this U.S. nationally representative managed care population, the majority of PsA patients receiving GLM was biologic-experienced and was appropriately prescribed a 50 mg dose on a monthly basis. Despite the history of biologic use, the majority of PsA patients using GLM did not have an apparent increased dose requirement upon initiation. Based upon the observed dosing patterns over the first 12 prescriptions, the estimated average annual per patient cost of GLM in a U.S. PsA population would be $22,135.
Disclosure of Interest C. Carter Employee of: Janssen Scientific Affairs, LLC, D. Smith Consultant for: Janssen Scientific Affairs, LLC, N. Tandon Employee of: Janssen Scientific Affairs, LLC