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. 2018 Feb;47(3):364-370.
doi: 10.1111/apt.14430. Epub 2017 Nov 22.

Market share and costs of biologic therapies for inflammatory bowel disease in the USA

H Yu  1 , D MacIsaac  1   2 , J J Wong  3 , Z M Sellers  1 , A A Wren  1 , R Bensen  1 , C Kin  2 , K T Park  1
Affiliations

Market share and costs of biologic therapies for inflammatory bowel disease in the USA

H Yu et al. Aliment Pharmacol Ther. 2018 Feb.

Abstract

Background: Real-world data quantifying the costs of increasing use of biologics in inflammatory bowel disease (IBD) are unknown.

Aim: To determine the outpatient IBD drug utilization trends, relative market share, and costs in the USA during a 9-year period.

Methods: The Truven MarketScan® Database was analysed for patients with Crohn's disease (CD) and ulcerative colitis (UC) during 2007-2015. National drug codes were used to identify prescription drugs; Healthcare Common Procedure Coding System J-codes were used to capture biologic out-patient infusions. Proportion of drug usage, relative market share and per-member per-year (PMPY) costs were analysed for biologics, immunomodulators, 5-ASAs and corticosteroids.

Results: In 415 405 patients (188 842 CD; 195 183 UC; 31 380 indeterminate colitis; 54.67% female), utilization trends show a consistent rise in the market share of biologics during the 9-year study period. The proportion of patients using biologics increased from 21.8% to 43.8% for CD and 5.1%-16.2% for UC. This contrasts a small decrease in immunomodulator and 5-ASA use for CD and relative constancy of other classes including corticosteroids-only use as primary IBD medication from 2007 to 2015. The average biologic-taking patient accounted for $25 275 PMPY in 2007 and $36 051 PMPY in 2015. The average paediatric biologic-taking patient accounted for $23 616 PMPY in 2007 and $41 109 PMPY in 2015. In all patients, the share of costs for biologics increased from 72.9% in 2007 to 85.7% in 2015 (81.7% in 2007 to 94.9% in 2015 in paediatrics).

Conclusion: The vast majority of costs allocated to out-patient IBD medications in the USA is attributed to increasing use of biologic therapies despite the relative minority of biologic-taking patients.

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Conflict of interest statement

Conflict of Interest & Funding Source: KTP has received research support from Janssen, Takeda, AbbVie Inc. unrelated to this work, and is supported by NIDDK094868 for this research. The remaining authors have no conflicts of interests to disclose. No form of payment or honorarium was given to any contributor for manuscript preparation or production.

Figures

Figure 1
Figure 1. Outpatient IBD Medication Utilization Trends
The proportion of patients using biologics increased for CD and UC, with a decrease in immunomodulator and 5-ASA use in CD and stable IBD medication use including corticosteroid-only from 2007 to 2015.
Figure 2
Figure 2. Increasing Market Share of Biologic Therapies
The proportion of patients using biologics and costs allocated to biologics compared to other IBD medications have increased every year from 2007 to 2015.
Figure 3
Figure 3. IBD Medication Per-Member Per Year (PMPY) Costs
Biologics outpace other medications in rate-of-increase and total PMPY costs.
See this image and copyright information in PMC

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