P503 Changes in clinical use of vedolizumab are driven by lower drug costs and are associated with better outcomes: a real-life single-centre Spanish experience
Y. Gonzalez Lama, M. Calvo, V. Matallana, I. Gonzalez-Partida, I. Omella, M.I. Vera
Department of Gastroenterology, University Hospital Puerta De Hierro, Majadahonda, Spain
Background
Vedolizumab (VDZ) has shown efficacy in the treatment of inflammatory bowel disease (IBD). Available data show better outcomes in naïve patients than in AntiTNFa experienced patients, and current ECCO guidelines support first-line use of VDZ since 2017. Nevertheless, reimbursement of VDZ was initially approved in Spain only in patients failing to at least one AntiTNFa agent (except contraindication) until January 2018 when, following a significative decrease in costs of VDZ, reimbursement was approved also in naïve patients. Our aim was to elucidate if our clinical use of vedolizumab have evolved after costs decrease, and if was associated with better clinical outcomes.
Methods
Retrospective review of all VDZ treated patients with at least 6 months of follow-up in a referral IBD Unit of a tertiary centre in Madrid (Spain) since December 2014. Demographics, clinical data and information regarding VDZ treatment were collected.
Results
118 IBD patients included (61(52%) Crohn’s disease, 57(48%) ulcerative colitis): 62(53%) female; median age 48(IQR 32–63) years. 64 patients started VDZ before 2018, 54 since January 2018. Among patients who started VDZ treatment before and after January 2018: 9(14%) and 22(41%) respectively were naïve to antiTNFa (
Conclusion
Lower costs have facilitated earlier use of VDZ in our clinical practice, towards increase use in patients who have failed to one single AntiTNFa agent or even naïve to AntiTNFa. This evolved a pattern of VDZ use is associated with better clinical outcomes in terms of VDZ intensification and/or withdrawn. Price policies facilitating appropriate access to drugs, such as VDZ, should be more easily and quickly acceptable by national health authorities. Patient-centred care demand best use of all available drugs, including VDZ.