Infusion administration billing for vedolizumab and infliximab in inflammatory bowel disease

Abstract

Aims: Increasing use of biologics has led to interest in treatment components with potential for cost savings. This study was aimed at comparing administration times and associated costs of infliximab and vedolizumab infusions for inflammatory bowel disease (IBD).

Materials and methods: This study used claims data from the Symphony Health Integrated Dataverse to identify IBD patients using infliximab or vedolizumab between 20 May 2014 and 29 February 2016. Use of Current Procedural Terminology administration codes was evaluated and costs calculated using the 2016 Center for Medicare and Medicaid Services Physician Fee Schedule. Assessments included infusion times, associated costs, productivity loss using average wage estimates from the United States Bureau of Labor Statistics, and home infusion adoption.

Results: A total of 10,051 infliximab and 3114 vedolizumab patients with first-hour claims were identified; 52.0% were female and 64.5% had Crohn’s disease. There were 48,377 infliximab first-hour claims (mean 4.8 infusions per patient); 46,462 (96.0%) had a second-hour claim. In comparison, there were 14,717 vedolizumab claims (mean 4.7 infusions per patient), with only 411 (2.8%) second-hour claims, resulting in vedolizumab cost savings of approximately $1.27 million. The difference in second-hour infusions resulted in 46,051 additional hours of productivity loss with infliximab, and lost wages averaging $1.18 million (range $0.68–$1.77 million).

Limitations: Administration costs were inferred as charge costs and not directly assessed. Productivity loss assessed time spent on infusion only, and included a small proportion of patients beyond working age.

Conclusions: Second-hour infusion billing was significantly lower with vedolizumab than with infliximab, corresponding to cost savings and reduced productivity loss.

Keywords:

• Vedolizumab
• infliximab
• inflammatory bowel disease
• infusion administration
• cost

JEL classification codes:

• I11
• I00

Transparency

Declaration of funding

This study was funded by Takeda Pharmaceuticals USA Inc.

Author contributions

All authors contributed to the study design and implementation. All authors contributed to the preparation of this manuscript and provided final approval for publication.

Declaration of financial/other relationships

K.N., T.L. and M.L. are employees of Takeda Pharmaceuticals USA Inc., Deerfield, IL, USA. V.K. has disclosed that he was employed as a University of Illinois at Chicago Fellow at Takeda Pharmaceuticals at the time the study was conducted.

JME peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Previous presentation: This work was presented at the American College of Gastroenterology 2016 Annual Scientific Meeting (Null K, et al. Assessing administration and billing of vedolizumab and infliximab across IBD sites of care, Poster P1917); the 2016 Advances in Inflammatory Bowel Diseases, Crohn’s & Colitis Foundation of America’s Clinical & Research Conference (Null K, et al. Comparing productivity between patients on vedolizumab and infliximab patients using infusion administration billing in the United States, Poster P-102. Kumar V, et al. Economic impact of infusion administration time billing for vedolizumab and infliximab for ulcerative colitis and Crohn’s disease: health plan perspective, Poster P-092); and the Academy of Managed Care Pharmacy 2017 Managed Care & Specialty Pharmacy Annual Meeting (Kumar V, et al. Economic impact of infusion administration time billing for vedolizumab and infliximab for ulcerative colitis and Crohn’s disease: health plan perspective, Poster K9).

Acknowledgements

Ann Cameron helped with a component of the literature review and provided background materials. Ann is an employee of Xcenda Inc. Medical writing assistance was provided by Alpa Parmar PhD and Bomina Yu PhD CMPP of inVentiv Medical Communications and funded by Takeda Pharmaceuticals USA Inc.