Cost of inflammatory bowel disease ‘immeasurable’

Inflammatory bowel disease is among the fastest-growing conditions in Canada, affecting one in 150 Canadians.

According to a recent study, the direct cost of inflammatory bowel disease is $1.2 billion a year. And that’s only part of the picture. “It is the disease, rather than the treatment, that is financially burdensome,” Dr. Cynthia Seow, assistant professor at the University of Calgary’s Cumming school of medicine, said during the Calgary Benefits Summit in April. “The true cost . . . is in indirect costs, in such things as lost days at work or school and reduced productivity. And the physical and psychological costs to patients are immeasurable.

“With biologic therapies, we can maintain patients in remission, with a significant decline in absenteeism and presenteeism. There is also a positive effect on health care resource utilization, with a decrease in hospitalizations and length of hospital stays. Biologic therapies are effective at improving quality of life, resulting in significant direct and indirect long-term cost savings.”

While biosimilars offer the potential for some savings, switching therapies isn’t as simple as comparing the cost of drugs, according to Seow.

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“Biosimilars are not bioequivalent,” she said. “One small processing change could mean that a biosimilar may not be as effective as the innovator drug in the long term.”

When a new biologic drug gets approval, she noted, it first undergoes an evaluation in terms of its safety, efficacy and quality before considering the cost issues. But with biosimilars, the reverse happens. “They are looking at production and costs first,” said Seow.

Seow also noted the limited information available so far from controlled trials comparing biologics to biosimilars. While a study that will soon appear in the medical journal Lancet found no significant difference in disease worsening at one year between the biologic versus the biosimilar, the results are somewhat controversial due to its design, she said.

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“There is a good lesson to be learned from their data. Non-medical switching is potentially a concerning issue for patients who are doing well on their existing medication.”