Cost Analysis of Certolizumab Pegol Compared With Available Biologic Agents For Crohn’s Disease In Mexico And Brazil

Abstract

Inflammatory bowel disease (IBD) is associated with high costs, high morbidity and decreased quality of life in patients. In Mexico and Brazil, there is no concise data about prevalence of Crohn's Disease (CD) estimated to range from 0.0008% to 1.11% and no cost data attributable to IBD. OBJECTIVE(S): To assess the average annual cost per patient with CD treated with biologics from the perspective of the government healthcare system both in Mexico and Brazil. METHOD(S): Biologic treatments examined included certolizumab pegol (CZP) 400 mg weeks 0, 2, 4 and then every 4 weeks; adalimumab (ADA) 160 mg week 0, 80 mg week 2 and then 40 mg every 2 weeks; infliximab (INF) 5 mg / kg at weeks 0, 2, 6, and every 8 weeks thereafter. Medication acquisition costs were assessed for CZP and ADA, while costs for INF assessed both acquisition and administration (infusion). Average weight per patient in the analyses was 70kg. Prices were obtained from the Mexican Social Security Institute (IMSS) and ANVISA for Brazil. Exchange rates were obtained from public sources (1USD= 0.0675MXN; 1USD= 2.7BRL). RESULT(S): The analysis for Mexico shows lower costs in the first year of treatment (induction and maintenance) with CZP (USD$7,719/year) vs ADA and INF (USD$12,792, USD$17,313/year, respectively), leading to cost savings per patient/year compared with CZP of approximately USD$5,073 and USD$9,594 versus adalimumab and infliximab. In Brazil, similar Resultswere seen: CZP (USD$7,186/year) versus ADA (USD$24,813/year) and INF (USD$31,004/year), showing savings with CZP of USD$17,627 vs ADA and USD$23,818 vs INF per year. The savings are even greater with CZP in the maintenance years. CONCLUSION(S): Certolizumab pegol shows savings when compared to adalimumab and infliximab in the first year of treatment and maintenance, which can lead to an important impact on institutional budgets.