PGI31 SENSITIVITY OF INCREASING BODY WEIGHT IN PATIENTS WITH COLLITIS ULCEROSA TO TOTAL COST OF TREATMENT

Abstract

A time-trend analysis of 40 clinical trials in Crohn’s disease showed a significant increase in the mean weight of patients from 57.5kg in 1997 to 89.1kg in 2008. The cost of current standard of care (SoC) for UC patients in Denmark is weight-dependent, in contrast to the newer therapeutic alternatives. Hence, the aim of this study is to analyze the sensitivity of body weight to total cost of treating UC patients in Denmark. We designed a total cost analysis including SoC infliximab, an anti-TNF, and two other mode of actions, an anti-integrin, vedolizumab and a JAK-inhibitor, tofacitinib. Drug costs were calculated using pharmacy purchasing prices assuming re-use of vials in the hospital setting (infliximab). Total cost included drug costs, hospital drug administration costs, patient time and travel costs. Both administration costs and patient’s costs were independent of weight. Patient education, monitoring of treatment effects and safety were assumed to be the same. Time horizon was 18 months and all costs after 12 months discounted by 4%. The analysis showed that the total cost of treating UC is sensitive to body weight. Total cost of treating patients for 18 months with SoC infliximab becomes more expensive than treating them with tofacitinib for patients above 81kg (tofacitinib DKK 135,573 and infliximab DKK 135,966). Cost of vedolizumab is not affected by weight and cost of treatment for 18 months is DKK 229.436. This study concludes that the total cost of treating UC patients in Denmark is sensitive to body weight, which affects the cost of drugs. For patients > 81kg, tofacitinib is a cheaper treatment option than current SoC. The current weight assumption guiding SoC in Denmark is 70kg. The results therefore suggest the need to revisit this assumption and possibly also the national medicine recommendations for UC.