Clinical and economic “real world” analysis of the switching from Remicade® (infliximabe reference) by Remsima™ (infliximab biossimilar) in patients with rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis

Abstract

Objective: Planserv offers coverage of biological therapy for rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PA). In August 2016, 78 patients were on Remicade® (infliximabe). At this date the value of Remicade® was reduced to the same value as Remsima™ (infliximabe biossimilar), with this all patients who were using Remicade® exchanged for Remsima™. We conduc[1]ted a study to measure therapy discontinuity, and economics. Methods: An uncontrolled real-world study (prospective cohort) these patients who were using Remicade® and switched to Remsima™ between September 2016 and September 2017. The primary outcome was the discontinuation rate of treatment (for any cause). The secondary outcome was the “increased disease activity” rate as measured by the scores SDAI, BASDAI and CASPAR. It was as “increased disease activity”, any measure higher than the initial, and that was above the remission limit of the disease. The reference values for “increased disease activity” were the historical measures. The economic impact measured by a cost minimization analysis. Results: In September 2017, 5 (6%) patients who switched from Remicade® to Remsima™, discontinued therapy (4 due to failure and 1 loss of follow-up). The reference discontinuation rate (Remicade®) was 11% (9% failure and 2% loss of follow-up). Subgroup analyzes (discontinuation of therapy by type of pathology) were equivalent. The rate of “increased disease activity” occurred in 42% of patients for Remsima™, and 46% for Remicade®. Subgroup analyzes (by type of pathology) also showed that rates of increase in disease activity were similar between groups. The economic analysis showed that the change from Remicade® to Remsima™ savings of R $ 1.75 million (US $ 0.5 million), with 1,689 ampoules of infliximabe dispensed in the period. Conclusion: The switching of Remicade® by Remsima™ in patients with RA, SA and PA in the context of Planserv, has been shown to be a safe, effective and economical measure.