Impact on direct and indirect costs of switching patients with inflammatory bowel disease from intravenous to subcutaneous infliximab (CT-P13)

BackgroundWe aim to compare the real-life direct and indirect costs of switching patients from intravenous to subcutaneous (SC) CT-P13, an infliximab biosimilar, in a tertiary UK Inflammatory Bowel Disease (IBD) centre.MethodsAll adult patients with IBD on standard dosing CT-P13 (5 mg/kg 8 weekly) were eligible to switch. Of 169 patients eligible to switch to SC CT-P13, 98 (58%) switched within 3 months and one moved out of area.ResultsTotal annual intravenous cost for 168 patients was 689 pound 507.04 (direct=653 pound 671.20, indirect=35 pound 835.84). After the switch, as-treated analysis demonstrated total annual cost for 168 patients (70 intravenous and 98 SC) was 674 pound 922.83 (direct = 654 pound 563, indirect = 20 pound 359.83) resulting in 891.80 pound higher cost to healthcare providers. Intention to treat analysis showed a total annual cost of 665 pound 961.01 (direct = 655 pound 200, indirect = 10 pound 761.01) resulting in 1528.80 pound higher cost to healthcare providers. However, in each scenario, the significant decrease in indirect costs resulted in lower total costs after switching to SC CT-P13.ConclusionsOur real-world analysis demonstrates switching from intravenous to SC CT-P13 is broadly cost neutral to healthcare providers. SC preparations have marginally higher direct costs, switching allows for efficient use of intravenous infusion units and reduces costs to patients.

Automated summary

Our study shows that switching patients from intravenous to subcutaneous CT-P13 is cost neutral, as it results in a decrease in indirect costs and allows for more efficient use of infusion units.