EMPIRICAL TIME-SERIES ANALYSES IN THE PAST THREE DECADES 1991-2023 FOR IMMUNE THROMBOCYTOPENIA MEDICATIONS IN THE US MEDICAID PROGRAMS
Author(s)
Shireen Halloush, MS , PhD student1, Jeff Jianfei Guo, PhD2;
1university of cinninati, PhD student, PLAIN CITY, OH, USA, 2James L Winkle College of Pharmacy, University of Cincinnati, Cincinnati, OH, USA
1university of cinninati, PhD student, PLAIN CITY, OH, USA, 2James L Winkle College of Pharmacy, University of Cincinnati, Cincinnati, OH, USA
OBJECTIVES: Retrospective study aims to comprehensively examine trends in the utilization, reimbursement, and price per prescription of ITP medications, to identify their patterns associated with drug approvals, biosimilar entry, and evolving clinical guidelines
METHODS: National Medicaid pharmacy claims summary data files from Center for Medicare and Medicaid Service were extracted and analyzed annually from 1991 -2023. Study medications target platelet count restoration and immune system modulation, including thrombopoietin receptor agonists (TPO-RA), such as Nplate (Romiplostim) and Promacta (Eltrombopag), and IV immunoglobulin (e.g., Gammagard) or anti-D immunoglobulin, Rituximab (an anti-CD20 monoclonal antibody), and newer Tyrosine kinase inhibitors. They were categorized into therapeutic classes and analyzed as trends in utilization (number of prescriptions), reimbursement (expenditure), and drug price over time. Comparative market-share analyses were also conducted within and across therapeutic classes
RESULTS: Utilization trends revealed Rituxan dominated until 2020, after which biosimilars (Ruxience, Truxima) gained traction, with Ruxience leading. In the IVIG category, Gammagard consistently held the highest utilization, peaking in 2022, followed by Rhophylac and Privigen. Among TPO-RAs, Promacta surpassed Nplate in 2018, reflecting a shift in prescribing patterns. Pricing data highlighted Promacta as the most expensive TPO-RA, while Panzyga led IVIG pricing by 2019. Despite a price decline after biosimilar approvals, Rituxan remained the costliest in its class. Reimbursement trends mirrored utilization, with Rituxan historically leading, followed by biosimilars. Gammagard achieved the highest IVIG reimbursement, while Promacta overtook Nplate post-2018. Across categories, IVIG had the highest utilization, but Rituxan maintained the largest reimbursement share due to its historical dominance.
CONCLUSIONS: Analysis highlights evolving patterns in the utilization, reimbursement, and pricing of ITP therapies within Medicaid programs, shaped by factors such as the introduction of biosimilars, competitive market dynamics, and clinical advancements. These findings provide valuable insights for healthcare policymakers, payers, and clinicians to optimize treatment access, manage costs, and enhance outcomes for patients .
METHODS: National Medicaid pharmacy claims summary data files from Center for Medicare and Medicaid Service were extracted and analyzed annually from 1991 -2023. Study medications target platelet count restoration and immune system modulation, including thrombopoietin receptor agonists (TPO-RA), such as Nplate (Romiplostim) and Promacta (Eltrombopag), and IV immunoglobulin (e.g., Gammagard) or anti-D immunoglobulin, Rituximab (an anti-CD20 monoclonal antibody), and newer Tyrosine kinase inhibitors. They were categorized into therapeutic classes and analyzed as trends in utilization (number of prescriptions), reimbursement (expenditure), and drug price over time. Comparative market-share analyses were also conducted within and across therapeutic classes
RESULTS: Utilization trends revealed Rituxan dominated until 2020, after which biosimilars (Ruxience, Truxima) gained traction, with Ruxience leading. In the IVIG category, Gammagard consistently held the highest utilization, peaking in 2022, followed by Rhophylac and Privigen. Among TPO-RAs, Promacta surpassed Nplate in 2018, reflecting a shift in prescribing patterns. Pricing data highlighted Promacta as the most expensive TPO-RA, while Panzyga led IVIG pricing by 2019. Despite a price decline after biosimilar approvals, Rituxan remained the costliest in its class. Reimbursement trends mirrored utilization, with Rituxan historically leading, followed by biosimilars. Gammagard achieved the highest IVIG reimbursement, while Promacta overtook Nplate post-2018. Across categories, IVIG had the highest utilization, but Rituxan maintained the largest reimbursement share due to its historical dominance.
CONCLUSIONS: Analysis highlights evolving patterns in the utilization, reimbursement, and pricing of ITP therapies within Medicaid programs, shaped by factors such as the introduction of biosimilars, competitive market dynamics, and clinical advancements. These findings provide valuable insights for healthcare policymakers, payers, and clinicians to optimize treatment access, manage costs, and enhance outcomes for patients .
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE507
Topic
Economic Evaluation
Disease
SDC: Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)