PATIENT CHARACTERISTICS AND UTILIZATION OF ADALIMUMAB-BWWD IN THE US DEPARTMENT OF VETERANS AFFAIRS POPULATION
Author(s)
Haopeng Liu, PharmD, MPH1, Connor Willis, PharmD1, Joanne Lafleur, MSPH, PharmD1, Jacob Crook, MS2, Xiangyang Ye, PhD2, Richard Nelson, PhD3, Jessica A. Walsh, MD2, Brian Seal, MBA, RPh, PhD4, Brian Meissner, PharmD, PhD4, Ricardo Infante, MD4, Sharan Lohithaswa, MD4, Gordon Goodall, PhD5, Carl V. Asche, BA, MBA, MSc, PhD1.
1Department of Pharmacotherapy, University of Utah, Salt Lake City, UT, USA, 2Veterans Affairs Salt Lake Health Care System, Salt Lake City, UT, USA, 3Division of Epidemiology, University of Utah, Salt Lake City, UT, USA, 4Organon & Co., Jersey City, NJ, USA, 5Organon International, Lucerne, Switzerland.
1Department of Pharmacotherapy, University of Utah, Salt Lake City, UT, USA, 2Veterans Affairs Salt Lake Health Care System, Salt Lake City, UT, USA, 3Division of Epidemiology, University of Utah, Salt Lake City, UT, USA, 4Organon & Co., Jersey City, NJ, USA, 5Organon International, Lucerne, Switzerland.
OBJECTIVES: The Veterans Health Administration (VHA) healthcare system replaced reference adalimumab on their formulary with biosimilar adalimumab-bwwd in March of 2024. We characterized patients on these medications and assessed the impact of the change.
METHODS: We analyzed electronic health record and administrative datasets from the VHA Corporate Data Warehouse (10/1/2015-8/1/2025). The index date was the first prescription date of adalimumab-bwwd or, for veterans treated exclusively with reference adalimumab, their first adalimumab prescription. Baseline and follow-up periods were 12 months before and after the index date. Veterans were required to have ≥ 1 clinical encounter during baseline. Veterans who used adalimumab-bwwd only or those who had used reference adalimumab ≤ 90 days before switching were classified as the adalimumab-naive cohort. Veterans that switched > 90 days after adalimumab were categorized as the adalimumab-experienced cohort. We used descriptive statistics to summarize patient characteristics and proportion of days covered (PDC) to measure adherence. We compared PDC across cohorts using the Mann-Whitney U test, with p < 0.05 considered significant.
RESULTS: During the study period, 11,363 adalimumab-naive and 16,321 adalimumab-experienced veterans received adalimumab-bwwd, and 30,722 veterans received reference adalimumab only. In the adalimumab-experienced cohort, veterans had a mean age of 60 years; 87% were male and 75% white. Baseline glucocorticoids use was 44% and non-adalimumab TNF inhibitors use was 10%. Common comorbidities included hypertension (51%), hyperlipidemia (51%), type 2 diabetes (27%), and depression (26%). Mean days of adalimumab exposure in the adalimumab-experienced cohort during the baseline period ranged from 251-291, depending on indication. Among adalimumab-experienced veterans, median (IQR) PDC for adalimumab-bwwd was 0.75 (0.50-0.87), higher than PDC for veterans who received reference adalimumab only (0.56 [0.29-0.81]; p < 0.001, Mann-Whitney U test).
CONCLUSIONS: Transitioning patients from higher-cost reference adalimumab to biosimilar adalimumab-bwwd was demonstrated to be feasible within the VHA system and associated with favorable adherence rates.
METHODS: We analyzed electronic health record and administrative datasets from the VHA Corporate Data Warehouse (10/1/2015-8/1/2025). The index date was the first prescription date of adalimumab-bwwd or, for veterans treated exclusively with reference adalimumab, their first adalimumab prescription. Baseline and follow-up periods were 12 months before and after the index date. Veterans were required to have ≥ 1 clinical encounter during baseline. Veterans who used adalimumab-bwwd only or those who had used reference adalimumab ≤ 90 days before switching were classified as the adalimumab-naive cohort. Veterans that switched > 90 days after adalimumab were categorized as the adalimumab-experienced cohort. We used descriptive statistics to summarize patient characteristics and proportion of days covered (PDC) to measure adherence. We compared PDC across cohorts using the Mann-Whitney U test, with p < 0.05 considered significant.
RESULTS: During the study period, 11,363 adalimumab-naive and 16,321 adalimumab-experienced veterans received adalimumab-bwwd, and 30,722 veterans received reference adalimumab only. In the adalimumab-experienced cohort, veterans had a mean age of 60 years; 87% were male and 75% white. Baseline glucocorticoids use was 44% and non-adalimumab TNF inhibitors use was 10%. Common comorbidities included hypertension (51%), hyperlipidemia (51%), type 2 diabetes (27%), and depression (26%). Mean days of adalimumab exposure in the adalimumab-experienced cohort during the baseline period ranged from 251-291, depending on indication. Among adalimumab-experienced veterans, median (IQR) PDC for adalimumab-bwwd was 0.75 (0.50-0.87), higher than PDC for veterans who received reference adalimumab only (0.56 [0.29-0.81]; p < 0.001, Mann-Whitney U test).
CONCLUSIONS: Transitioning patients from higher-cost reference adalimumab to biosimilar adalimumab-bwwd was demonstrated to be feasible within the VHA system and associated with favorable adherence rates.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
HSD27
Topic
Health Service Delivery & Process of Care
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain), STA: Biologics & Biosimilars