1. Costs of Providing Infusion Therapy for Rheumatoid Arthritis in a Hospital-based Infusion Center Setting
- Author
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Jordana K. Schmier, Arijit Ganguli, Yanjun Bao, Kristine Ogden, Vishvas Garg, Nancy A. Nickman, Mary A. Cifaldi, and Michael T. Halpern
- Subjects
medicine.medical_specialty ,Antibodies, Monoclonal, Humanized ,Abatacept ,Arthritis, Rheumatoid ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Tocilizumab ,Infusion therapy ,medicine ,Humans ,Pharmacology (medical) ,Hospital Costs ,Infusions, Intravenous ,Activity-based costing ,Home Infusion Therapy ,health care economics and organizations ,030203 arthritis & rheumatology ,Pharmacology ,business.industry ,030503 health policy & services ,Hospital based ,medicine.disease ,Infliximab ,United States ,Models, Economic ,chemistry ,Antirheumatic Agents ,Rheumatoid arthritis ,Emergency medicine ,Physical therapy ,Rituximab ,0305 other medical science ,business ,medicine.drug - Abstract
Purpose Many hospital-based infusion centers treat patients with rheumatoid arthritis (RA) with intravenous biologic agents, yet may have a limited understanding of the overall costs of infusion in this setting. The purposes of this study were to conduct a microcosting analysis from a hospital perspective and to develop a model using an activity-based costing approach for estimating costs associated with the provision of hospital-based infusion services (preparation, administration, and follow-up) in the United States for maintenance treatment of moderate to severe RA. Methods A spreadsheet-based model was developed. Inputs included hourly wages, time spent providing care, supply/overhead costs, laboratory testing, infusion center size, and practice pattern information. Base-case values were derived from data from surveys, published studies, standard cost sources, and expert opinion. Costs are presented in year-2017 US dollars. The base case modeled a hospital infusion center serving patients with RA treated with abatacept, tocilizumab, infliximab, or rituximab. Findings Estimated overall costs of infusions per patient per year were $36,663 (rituximab), $36,821 (tocilizumab), $44,973 (infliximab), and $46,532 (abatacept). Of all therapies, the biologic agents represented the greatest share of overall costs, ranging from 87% to $91% of overall costs per year. Excluding infusion drug costs, labor accounted for 53% to 57% of infusion costs. Implications Biologic agents represented the highest single cost associated with RA infusion care; however, personnel, supplies, and overhead costs also contributed substantially to overall costs (8%–16%). This model may provide a helpful and adaptable framework for use by hospitals in informing decision making about services offered and their associated financial implications.
- Published
- 2017