Background: Crohn’s disease treatment costs with certolizumab pegol (CZP) have been shown to be lower than infliximab (IFX), mainly due to lower CZP drug costs. Here, we examined the one-year (yr) all-cause healthcare resource utilization (HRU) and costs, incurred by CD patients (pts) with CZP vs IFX. Methods: Data (2008–2015) were analyzed from the Truven MarketScan® database. Inclusion criteria: CD diagnosis, CZP/IFX treatment index date 7/2008–12/2014, eligibility ±12 months of index date, age ≥18yrs. Mean, unadjusted one-yr HRU and costs were compared between groups via Mann-Whitney U tests. Multivariate (MV) regression models were used to adjust for treatment (CZP/IFX), prior biologic use (yes/no), gender, age, and baseline patient characteristics (Charlson comorbidity index, HRU, costs). Results: 784 CD pts were treated with CZP and 3,272 with IFX. CZP pts were more likely to have prior biologic use than IFX pts (Table 1). In unadjusted analyses, CZP pts had increased pharmacy usage compared to IFX pts; CZP pts also had similar physician office visits and fewer outpatient (OP) visits (Fig.1A), resulting in greater overall pharmacy costs but lower medical expenditure than IFX pts (Fig.1B). In MV adjusted analyses, prior biologic use was associated with increased OP visits, emergency room utilization, and higher total medical costs. Although the CZP group had more biologic-experienced pts, CZP treatment was associated with fewer physician office and OP services (Fig.2A) compared to IFX pts, but greater pharmacy spend (Fig.2B). Overall, CZP treatment was associated with reduced total healthcare costs compared to IFX ($2,000 saving per pt per yr; Fig.2B). Conclusion: Despite CZP pts having a higher rate of prior biologic use, which has been correlated with more severe disease, annual all-cause healthcare costs were lower compared to IFX pts. Adjusted MV models showed that CZP treatment was associated with >$2,000 saving per pt per yr compared to IFX treatment.
