Study Summary: Crohn's Disease Dose Escalation

Crohn’s disease (CD) biologics, such as Humira (adalimumab) and Remicade (infliximab), are a source of significant spend for health plans and employers. While CD biologics are effective at controlling symptoms of the disease, doses are often escalated beyond FDA-approved labeling based on how patients respond to treatment. Quantifying the extent to which dose escalation occurs and its clinical and financial ramifications is important for health plans so they can support safe and appropriate patient care and reduce health care costs.

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Evio conducted one of the first real-world evidence studies identifying the incidence of dose escalation and its impact on clinical and financial outcomes.

Dose escalation was analyzed among the following medications: Humira (adalimumab), adalimumab biosimilars, Remicade (infliximab),infliximab biosimilars, Stelara, and Entyvio.

Evio’s study found:

• Dose escalation occurred in 34% to 60% of patients, ranging across medications
• Serious infections occurred in 20% to 35% of patients experiencing dose escalation versus 14% to 25% of patients not experiencing dose escalation
• Total cost of care was $14,000 to $34,000 higher for patients experiencing dose escalation compared to patients not experiencing dose escalation

Findings of the study can be used by plans in a variety of ways, including to target prescribers and prescribers for outreach, design utilization management, and prioritize monitoring of these agents.

If recommendations are implemented, health plans could realize $2.7M per 1M lives in potential cost savings and patients could experience improved health outcomes and total cost of care reductions.

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About Evio Insights

Evio conducts RWE studies using data from 26+M de-identified lives, 1B+ medical and pharmacy claims, and 5 years of longitudinal data with 50 states represented. Learn more about Evio Insights.

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