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biologics, biologic response modifiers, prescription drug utilization, costs
Few details are available about the factors driving cost increases of biologic medications.
To describe trends in utilization and cost of biologic agents using administrative databases in Saskatchewan, Canada.
Two analyses were conducted. First, aggregate utilization of biologics based on prescriptions dispensed was measured in each calendar year between 2001 and 2013. Second, a retrospective cohort of new biologic users was created to examine trends in spending between 2001 and 2013. During the first year of biologic therapy, biologic cost was quantified for each specific biologic agent as: (a) total spending; (b) total mil - ligrams dispensed; and (c) estimated unit cost (i.e., total cost in 2013 $CAD divided by total milligrams dispensed during the year). Data analyses were descriptive and all biologic costs were adjusted to 2013 dollars (CAD).
In the first year of biologic availability in Saskatchewan (2001), 133 patients were dispensed at least one biologic agent for a total cost of $0.5 million. In 2013, 2,402 biologic recipients were identified for a total cost of $51.8 million. Almost all of these biologic costs (88.9%) were paid by the provincial government. In 2013, infliximab was the most frequently used agent, accounting for 46.5% of all spending on biolog - ics. Infliximab was also the most expensive agent in 2013 (mean cost $31,340 ± 15,307) and showed the highest increase in the mean yearly cost over time due to greater quantities dispensed.
Biologic utilization will require ongoing monitoring to optimize patient-level and societal-level benefits.
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