P1101 (S0464). - Cost Reduction Associated With Improvement in Work Productivity Loss From Ustekinumab Treatment by Disease Severity States in Crohn’s Disease Patients: Results From the IM-UNITI Clinical Trial
Amanda Teeple1, Erik Muser, PharmD, MPH1, Dominik Naessens, PhD2, Béranger Lueza, PhD3, Zahra Kamal, MSc4, Astrid Foix Colonier, MSc3, Claudia Carlucci, MSc5; 1Janssen Scientific Affairs, LLC, Horsham, PA; 2Janssen Pharmaceutica NV, Beerse, Antwerpen, Belgium; 3Amaris, Health Economics and Market Access, France, Paris, Ile-de-France, France; 4Amaris, Health Economics and Market Access, Canada, Toronto, ON, Canada; 5Amaris, Health Economics and Market Access, UK, London, England, United Kingdom
Introduction: The economic burden associated with work productivity loss (WPL) is substantial in patients with Crohn’s Disease (CD). The objective of this study was to model the indirect costs associated with WPL for patients with CD treated with ustekinumab (UST) using US dollars. Methods: The average percentage of work time missed (absenteeism) and impairment in productivity while at work (presenteeism) due to CD were calculated using Work Productivity and Activity Impairment (WPAI) scores from a prior study of the Adelphi Disease Specific Programme (1). Patient-level data from the IM-UNITI trial was used to classify patients into disease severity states at week 44 in maintenance based on the Crohn’s Disease Activity Index (CDAI): remission (rem) (0-150), mild (151-220) and moderate to severe (mod/sev) ( > 220). The total costs associated with WPL (absenteeism + presenteeism) were estimated for each state using WPL data from the Adelphi study and an annual salary of $54,906 reported by the Bureau of Labor Statistics and the Census Bureau in 2018. Results: Of the 248 patients treated with UST 6mg/kg at induction and 90mg every 8 or 12 weeks at maintenance (UST 6-UST 90 Q8W/Q12W), 53%, 16% and 31% were in rem, mild and mod/sev states at week 44 of maintenance, respectively. Similarly, 54%, 16% and 29% of patients treated with UST 6-UST 90 Q8W (n=178) and 15%, 15% and 69% of the patients in the placebo induction arm (n=399) were in rem, mild and mod/sev states, respectively. The average costs of absenteeism and presenteeism per state were estimated as $527 and $6,307 for remission, $2,462 and $14,773 for mild, and $8,001 and $19,989 for mod/sev states, respectively. A patient remaining in the mod/sev state had an annual WPL associated cost of $27,990. Figure 1 reports the average costs for a CD patient among arms. Relative to remaining in a mod/sev state, the annual cost associated with reductions in WPL were estimated as $12,912, $13,238, and $4,901 for UST 6-UST 90 Q8W/Q12W, UST6-UST 90 Q8W and placebo, respectively. Treatment with UST 6-UST90 Q8W over a year is estimated to save $8,337 per patient compared to placebo. Discussion: Costs associated with WPL were lower for patients treated with UST than for placebo patients. The considerable cost reduction in WPL estimated for UST was threefold higher versus placebo. (1) Obando et al. Work productivity loss and associated indirect costs for patients with Crohn’s disease in the US. AMCP Nexus 2019; Abstract K5.
Figure 1 Average annual WPL costs per-patient per arm and for a patient remaining in a moderate to severe state
Disclosures: Amanda Teeple: Janssen Scientific Affairs LLC – Employee. Johnson & Johnson – Stockholder/Ownership Interest (excluding diversified mutual funds). Erik Muser: Janssen Scientific Affairs, LLC – Employee. Johnson & Johnson – Employee, Stockholder/Ownership Interest (excluding diversified mutual funds). Dominik Naessens: Johnson & Johnson – Employee, Stockholder/Ownership Interest (excluding diversified mutual funds). Béranger Lueza indicated no relevant financial relationships. Zahra Kamal indicated no relevant financial relationships. Astrid Foix Colonier indicated no relevant financial relationships. Claudia Carlucci indicated no relevant financial relationships.