MA2 Observation of Persistence Rates and Potential Cost Savings Associated With Certolizumab Pegol Treatment for Rheumatoid Arthritis in England, Wales and Northern Ireland Clinical Practice

Abstract

OBSERVATION OF PERSISTENCE RATES AND POTENTIAL COST SAVINGS ASSOCIATED WITH CERTOLIZUMAB PEGOL TREATMENT FOR RHEUMATOID ARTHRITIS IN ENGLAND, WALES AND NORTHERN IRELAND CLINICAL PRACTICE Russell M1, Timoshanko J1, Smets E2, Duncan G3, Spandley A1, Roskell S4 1UCB Pharma, Slough, UK, 2UCB Pharma, Brussels, Belgium, 3Healthcare at Home Ltd, Burton on Trent, UK, 4Cannock Chase Hospital, Cannock, UK OBJECTIVES: In the UK, access to anti-TNF therapies for the treatment of rheumatoid arthritis (RA) is standardized by National Institute for Clinical Excellence guidance. Certolizumab pegol (CZP) studies in RA demonstrate that patient response to therapy at 12 weeks predicts clinical outcome at 1 year. In the UK, CZP is available via a Patient Access Scheme (PAS), providing CZP free for the first 12 weeks. This analysis examines persistency and potential cost savings realised with a 12 week CZP decision. METHODS: A retrospective analysis examined 2,744 patients receiving CZP between March 2010 and March 2012 from Healthcare at Home, a UK home health care service provider. Persistence was defined as patients (%) continuing to receive CZP deliveries, calculated at specific time points. Treatment start was first delivery date and patients were censored according to this. A simple cost analysis was performed. RESULTS: At 13, 26, 39 and 52 weeks, persistence rates were 93%, 79%, 70% and 65% in naive (no prior anti-TNF) and 88%, 68%, 56% and 48% in switch ( 1 prior anti-TNF) patients respectively. Analyzing first-line biologic drug costs only, the NHS would save £2,363.14/patient in the first year if CZP were used instead of adalimumab (assuming similar persistence); largely due to the PAS. Stopping treatment for non-responders at Week 12 (CZP) vs Week 24 (adalimumab), could allow the UK NHS to re-invest £ 2145/patient. CONCLUSIONS: In this UK cohort, CZP persistence was higher in naive pts. Reinforcing a 12 week treatment decision could result in more efficient spend on drugs and rapid initiation of alternative treatment in non-responders.