Casey Chapman, MD1, Bincy P. Abraham, MD, MS, FACG2, Parakkal Deepak, MBBS, MS3, Tianzhou Yu, PhD, MS, MPH4, Jenny Griffith, PharmD5, Si Xuan, PhD6, Brooke Kim, RN, BSN, MS4, Cecile Holweg, PhD4, Jae Rok Kim, PharmD, MS7, Corey A.. Siegel, MD, MS8 1GI Alliance, Baton Rouge, LA; 2Houston Methodist-Weill Cornell, Houston, TX; 3Washington University in St. Louis, St. Louis, MO; 4AbbVie, Mettawa, IL; 5AbbVie, Edwardsville, IL; 6AbbVie, Lake County, IL; 7AbbVie, Irvine, CA; 8Dartmouth-Hitchcock Medical Center, Lebanon, NH
Introduction: Newly-approved advanced therapies in Crohn’s disease (CD) or ulcerative colitis (UC) may take longer for patients to access. Here, the time needed to access advanced therapy for patients with CD or UC was evaluated.
Methods: The Symphony Health Solutions administrative claims database was used to identify claims associated with the index treatment (biologic or small molecule oral medication) made between January 1, 2006, and December 31, 2023. Eligible patients for this retrospective cohort study were ≥18 years old at the index date (date of first claim after January 1, 2023), had ≥1 claims associated with a CD or UC diagnosis ≤6 months (mo) before the index date, had no claims associated with the index treatment before the index date, had ≥6mo of baseline medical/pharmacy coverage (≥1 medical and pharmacy claim ≤6mo before the index date) and ≥1 claim associated with gastroenterologist (GI) visit ≤3mo before the index date. The base case analysis used the last GI visit before the index date as the proxy for the prescription date of issue. Time to access (number of days [d] from the last GI visit to the index date for each drug-disease cohort) was assessed by disease (CD versus [vs] UC) and drug type (infusion vs self-administered) using analysis of variance. Subgroup analyses based on prior use of advanced therapy were also conducted. Sensitivity analysis compared the time to access self-administered drugs calculated in the base case and actual prescription written date.
Results: The average time to access infused treatments ranged from 27.8d to 33.6d with infliximab (and biosimilars) in CD and UC, having significantly shorter times relative to other therapies (Table). The average time to access self-administered therapies ranged from 27.3d to 34.9d, with upadacitinib (UPA) having significantly shorter times relative to other therapies. Subgroup analyses by prior use of advanced therapy revealed a similar pattern with the base case. Sensitivity analyses using the actual prescription written date for self-administered drugs showed the time to access was shorter compared to using the prior GI visit as a proxy, with average time ranging from 9.0d with UPA (UC) to 30.5d for ozanimod.
Discussion: While there are significant differences in the time needed for patients with CD or UC to access advanced therapies, the differences are relatively small for infused therapies. A key limitation to this analysis is the inability to evaluate the impact of drug samples on access time.
Note: The table for this abstract can be viewed in the ePoster Gallery section of the ACG 2024 ePoster Site or in The American Journal of Gastroenterology's abstract supplement issue, both of which will be available starting October 27, 2024.
