RA Issues: Cost & Biosimilars
A growing issue with RA therapy is the cost of treatment. Medicaid spending on biologics between 2013–2017 increased from $894 million to $3.1 billion, and Medicare spending between 2012–2017 increased from $4.3 billion to $10 billion, with only a modest increase in the number of patients being treated.8,9
One potential solution for the cost crisis in drug spending may be biosimilars. “Remarkable savings” have been seen in Europe with biosimilars, Dr. Weinblatt said. Although it’s unclear what the U.S. biosimilar market will look like, they could offer more cost-effective options for patients and physicians.
“We want the option to treat the patients that are appropriate with the drugs that are appropriate,” Dr. Weinblatt said. “Cost barriers are increasing, and the prior authorization process is becoming even more difficult. I hope biosimilars will give patients and rheumatologists the opportunity to prescribe the appropriate drugs without the current prior authorization hassles. We have made remarkable strides in the care of patients with RA, and we want this to continue.”
Kimberly Retzlaff is a freelance medical journalist based in Denver.
References
- Rohr MK, Mikuls TR, Cohen SB, et al. Underuse of methotrexate in the treatment of rheumatoid arthritis: A national analysis of prescribing practices in the US. Arthritis Care Res (Hoboken). 2017 Jun;69(6):794–800.
- Moghadam MG, Ten Klooster PM, Vonkeman HE, et al. Impact of stopping tumor necrosis factor inhibitors on rheumatoid arthritis patients’ burden of disease. Arthritis Care Res (Hoboken). 2018 Apr;70(4):516–524.
- Giles JT, Sattar N, Gabriel S, et al. Cardiovascular safety of tocilizumab versus etanercept in rheumatoid arthritis: A randomized controlled trial. Arthritis Rheumatol. 2020 Jan;72(1):31–40.
- Fleischmann R, Pangan AL, Song I-H, et al. Upadacitinib versus placebo or adalimumab in patients with rheumatoid arthritis and an inadequate response to methotrexate: Results of a phase III, double‐blind, randomized controlled trial. Arthritis Rheumatol. 2019 Nov;71(11):1788–1800.
- Lilly. Baricitinib (LY3009104): Rheumatoid Arthritis (briefing document). NDA 207924. FDA Advisory Committee Meeting. 2018 Apr 23.
- XELJANZ XR (tofacitinib): Increased risk of death/blood clots. Important safety information.
- Xeljanz to be used with caution for all patients at high risk of blood clots. European Medicines Agency. 2019 Oct 31.
- Dalal D, Zhang T, Shireman T. Medicaid spending (2013–2017) on disease modifying agents commonly used in rheumatoid arthritis [abstract]. Arthritis Rheumatol. 2019;71(suppl 10).
- Dalal D, Zhang T, Shireman T. Medicare spending (2012–2017) on disease modifying agents commonly used in rheumatoid arthritis [abstract]. Arthritis Rheumatol. 2019;71(suppl 10).