Segment 7 - Making Decisions in the Use of Biologic Agents Versus Conventional Therapies

When it comes to biologics like Rituxan and Remicade, which are intravenous infusions, decision making can be impacted by cost. Dr Fendrick asked the panelists what might hypothetically happen if cost was taken out of the equation when choosing between biologics and other RA treatments.

Dr O’Dell said that if cost could be taken out of the equation, there are several factors that can impact decision making. For example, studies show that biologics and conventional therapies are essentially equal in their ability to get a response from patients. Furthermore, rheumatologists could also choose treatments based on their convenience to administer, as well as their differing toxicity levels. He noted that while conventional therapies may have more associated side effects, biologics often have more severe side effects.

Dr Fendrick said that many payers are moving toward care models that would permit patients access to the right drugs at the right time. He added that he considers RA is a disease that lends itself to multiple therapeutic decisions to be made along the continuum care.

Dr Ruderman commented that when it comes to theoretical cost-free biologic use, there’s likely to be a difference between infusion and self-injectable agents. He said that diverse practice settings can make an additional difference. Dr Ruderman also made comments based on the availability of oral therapies, and how they influence the outcomes of patients with RA.