REAL-WORLD ECONOMIC OUTCOMES ASSOCIATED WITH SWITCHING BETWEEN BIOLOGICS AND BIOSIMILARS IN IMMUNE-MEDIATED INFLAMMATORY DISEASES
Author(s)
Kirti Batra, MBA1, Phani Veeranki, MPH, DrPH, MD2, Anuj Gupta, M.Sc.3;
1Optum Global Solutions, Noida, India, 2Optum Life Sciences, CYPRESS, TX, USA, 3Optum Life Sciences, Noida, India
1Optum Global Solutions, Noida, India, 2Optum Life Sciences, CYPRESS, TX, USA, 3Optum Life Sciences, Noida, India
OBJECTIVES: Biosimilars offer the potential to reduce treatment costs for immune‑mediated inflammatory diseases (IMIDs); however, real‑world evidence on the clinical and economic impact of switching from biologics to biosimilars remains limited.
METHODS: This retrospective cohort study used Optum’s Market Clarity Integrated Clinical and Claims database (January 1, 2016-June 30, 2025) to identify patients with ≥1 IMID diagnosis and ≥1 post‑diagnosis claim for adalimumab or infliximab (biologic or biosimilar). Patients who switched from biologic to biosimilar therapies were classified as switchers (index date: first switch), while non‑switchers remained on their initial therapy. All patients were continuously enrolled for 12 months before and after index date. Study outcomes included all‑cause healthcare resource utilization and costs on a per‑patient‑per‑month (PPPM) basis, and treatment persistence through 12 months. Descriptive and difference‑in‑differences (DiD) analyses were conducted.
RESULTS: A total of 256,831 IMID patients receiving adalimumab or infliximab biologics or biosimilars were identified (mean ± SD age 49.2 ± 14.8 years; 63.1% female; mean ± SD Charlson comorbidity index 1.14 ± 1.40). During the 12‑month follow‑up period, switchers incurred significantly lower mean all‑cause healthcare costs compared with non‑switchers (PPPM: $9,488 vs $12,121; p<0.001), driven primarily by lower pharmacy costs ($91.8k vs $125.1k; p<0.001). Health care utilization was higher among switchers than non‑switchers across most medical utilization categories (p<0.001). Treatment persistence at 12 months was significantly greater among switchers compared with non‑switchers (68.3% vs 41.7%; p<0.001). DiD analysis demonstrated a significant reduction in 12‑month all‑cause costs associated with switching (−$60.5k; p<0.001).
CONCLUSIONS: Patients on biologics who switched to biosimilars reported lower all‑cause healthcare costs, primarily driven by lower pharmacy costs. Additionally, higher treatment persistence suggest that switching to biosimilars may yield economic benefits while maintaining treatment continuity. Future research should further examine the impact by individual biologics and also evaluate underlying drivers of switching to biosimilars among IMID patients on biologics.
METHODS: This retrospective cohort study used Optum’s Market Clarity Integrated Clinical and Claims database (January 1, 2016-June 30, 2025) to identify patients with ≥1 IMID diagnosis and ≥1 post‑diagnosis claim for adalimumab or infliximab (biologic or biosimilar). Patients who switched from biologic to biosimilar therapies were classified as switchers (index date: first switch), while non‑switchers remained on their initial therapy. All patients were continuously enrolled for 12 months before and after index date. Study outcomes included all‑cause healthcare resource utilization and costs on a per‑patient‑per‑month (PPPM) basis, and treatment persistence through 12 months. Descriptive and difference‑in‑differences (DiD) analyses were conducted.
RESULTS: A total of 256,831 IMID patients receiving adalimumab or infliximab biologics or biosimilars were identified (mean ± SD age 49.2 ± 14.8 years; 63.1% female; mean ± SD Charlson comorbidity index 1.14 ± 1.40). During the 12‑month follow‑up period, switchers incurred significantly lower mean all‑cause healthcare costs compared with non‑switchers (PPPM: $9,488 vs $12,121; p<0.001), driven primarily by lower pharmacy costs ($91.8k vs $125.1k; p<0.001). Health care utilization was higher among switchers than non‑switchers across most medical utilization categories (p<0.001). Treatment persistence at 12 months was significantly greater among switchers compared with non‑switchers (68.3% vs 41.7%; p<0.001). DiD analysis demonstrated a significant reduction in 12‑month all‑cause costs associated with switching (−$60.5k; p<0.001).
CONCLUSIONS: Patients on biologics who switched to biosimilars reported lower all‑cause healthcare costs, primarily driven by lower pharmacy costs. Additionally, higher treatment persistence suggest that switching to biosimilars may yield economic benefits while maintaining treatment continuity. Future research should further examine the impact by individual biologics and also evaluate underlying drivers of switching to biosimilars among IMID patients on biologics.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE102
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Gastrointestinal Disorders, SDC: Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal), STA: Biologics & Biosimilars