Abstract
Introduction: Infliximab (IFX) is a monoclonal antibody widely used in the treatment of autoimmune diseases. However, its high cost often limits access to therapy. With the advent of biosimilars (BSMs), which are authorized copies of reference biologic medications at reduced costs, this scenario has the potential to change. Switching from a reference medication to its biosimilar counterpart is expected to result in significant cost savings while maintaining comparable clinical efficacy, thereby promoting a sustainable relationship between the healthcare system and treatment access. Objective: This study aims to evaluate the financial impact through a cost-minimization analysis of the reference and biosimilar versions of IFX in a health insurance company covering more than 500,000 individuals in Curitiba, Paraná. Methodology: This retrospective and descriptive study conducted a cost-minimization analysis among beneficiaries who used IFX from January 1, 2016, to December 31, 2017, using secondary data extracted from the health insurance company's computerized system. The study assessed potential substitution between the drugs to describe the hypothetical cost savings. Exclusion criteria included improper technology payment, non-payment, and justified deductions. After exclusions, individual and total expenses for IFX were calculated based on the costs of the drug presentations. Direct and indirect costs of materials and healthcare professionals involved in patient care were not included in the calculation. Economic analyses were performed using Microsoft Excel®, version 2007. Results: The study identified 185 patients, totaling 1,441 approvals, who used the reference IFX during the evaluation period. Of these, 31 approvals were excluded based on pre-defined criteria, leaving 1,410 approvals included in the study. The cost analysis revealed the use of 5,354 vials of reference IFX across 13 specialties, totaling R$ 22,937,911.30 in expenses, which included technology costs and infusion fees. The average cost per approval was R$ 16,268.02 (±R$ 4,257.91), and per patient was R$ 123,988.71 (±R$ 84,855.52). Upon applying the hypothetical switch to biosimilar IFX, the adjusted cost decreased to R$ 16,099,739.66, with an average cost per approval of R$ 11,418.26 (±R$ 2,975.37) and per patient of R$ 87,025.62 (±R$ 59,419.06). This resulted in a differential cost saving of R$ 6,838,171.64. Conclusion: Economic analysis in the treatment with immunobiologics proves highly relevant as it contributes to optimizing the use of costly therapies and ensuring the sustainability of the healthcare system. Biosimilar medications emerge as a cost-minimization option compared to reference treatments in the context of supplementary healthcare.
