IMPACT OF COLCHICINE PRICE INCREASE AND MARKET EXCLUSIVITY ON COLCHICINE ADHERENCE AND GOUT-RELATED HEALTHCARE RESOURCE UTILIZATION AND COSTS IN PATIENTS WITH GOUT
Author(s)
Sharma D1, Lee TA1, Touchette D1, Qato D1, Galanter WL2, Walton SM1
1Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA, 2Department of Medicine, Section of Academic Internal Medicine & Geriatrics, University of Illinois at Chicago, College of Medicine,, Chicago, IL, USA
OBJECTIVES: Following FDA enforcement (September, 2010) to remove all unapproved colchicine from the market, 2011 onwards only one brand of FDA approved colchicine was available and at a much higher price. The objective of this analysis is to evaluate the effect of the price increase of colchicine on prophylactic colchicine adherence and gout-related healthcare resource utilization and prescription costs. METHODS: This retrospective cohort study used data from the Truven Health MarketScan Commercial and Medicare Supplemental databases (2009-2012). New users of prophylactic colchicine were identified pre and post January 1st, 2011. To be eligible, new users had to have a minimum supply of 25 days for their index colchicine prescription, be ≥ 18 years, and continuously enrolled for six months before and after the index colchicine order. 6-month adherence, measured using a threshold of 80% of the proportion of days covered (PDC), was compared between two cohorts using logistic regression. Aggregated 6-month gout-related resource utilization (inpatient, outpatient and emergency department) and prescription costs (2017 USD) were also compared. All models adjusted for baseline patient characteristics. RESULTS: 22,080 and 20,154 patients met the eligibility criteria in the pre and post cohorts. Compared with the pre cohort, a non-significant decrease in 6-month adherence was observed in the post cohort (Adjusted OR: 0.95 (95% CI: 0.90, 1.01)). Post cohort patients were more likely to have gout-related resource utilization than pre cohort patients (adjusted OR outpatient: 1.39 (95% CI: 1.32, 1.44); adjusted OR inpatient: 1.13 (95% CI: 0.96, 1.34); adjusted OR emergency: 1.20 (95% CI: 1.04, 1.38)). Among gout specific prescriptions, the post-cohort was associated with higher total 6-month colchicine costs (Adjusted difference: $573, p< 0.0001) and higher costs to patients (Adjusted difference: $100, p< 0.0001). CONCLUSIONS: Colchicine’s price increase did not significantly impact adherence. However, gout related resource use increased following the policy.
Conference/Value in Health Info
2019-05, ISPOR 2019, New Orleans, LA, USA
Value in Health, Volume 22, Issue S1 (2019 May)
Code
PMS36
Topic
Economic Evaluation, Health Policy & Regulatory, Patient-Centered Research
Topic Subcategory
Adherence, Persistence, & Compliance, Cost/Cost of Illness/Resource Use Studies, Pricing Policy & Schemes, Reimbursement & Access Policy
Disease
Musculoskeletal Disorders