Results from two retrospective analyses sponsored by Mallinckrodt plcshow that use of the company’s H.P. Acthar® Gel (repository corticotropin injection) offers a cost-effective alternative in the management of dermatomyositis and polymyositis (DM/PM). Results were presented in poster sessions at the American Society of Health-System Pharmacists Summer Meetings, held June 11-15, in Baltimore.

Researchers compared non-medication-related medical resource use between patients treated with Acthar and patients treated with intravenous immunoglobulin (IVIG) and/or rituximab for DM/PM. Claims data of DM/PM patients were analyzed from the combination of three commercial health insurance databases in the U.S. from July 1, 2009 to June 30, 2014.

Findings from this retrospective, observational study among DM/PM patients include:

• Very few patients had used Acthar (n=132), while use of IVIG (n=1,150) or rituximab (n=562) was more common
• Compared to IVIG: Acthar patients had fewer per patient per month (PPPM) hospitalizations (0.09 vs. 0.17; P=0.049); shorter length of stay (LOS) (3.24 days vs. 4.55 days; P=0.004); PPPM hospital outpatient department (HOPD) visits (0.60 vs. 1.39; P < 0.001); and PPPM physician office visits (2.01 vs. 2.33; P=0.035)
• Compared to rituximab, Acthar had fewer PPPM HOPD visits (0.56 vs. 0.92; P < 0.001)
• Compared to IVIG + rituximab, Acthar had shorter LOS (2.18 days vs. 5.15; P < 0.001) and less PPPM HOPD visits (0.53 vs. 1.26; P < 0.001)
• Total non-medication PPPM costs were lower for Acthar compared to IVIG ($2,126 vs. $3,964; 
• P < 0.001), rituximab ($2,008 vs. $2,607; P=0.018) and IVIG+rituximab ($1,234 vs. $4,858; 
• P < 0.001)

In reporting the findings, Mallinckrodt notes that the study examined only non-medication medical resource use and associated non-medication costs. Other endpoints such as indirect healthcare costs, patient experience and quality-of-life measures, and effectiveness were not examined. Propensity score matching was used to control for potential confounders; however, the use of propensity scores will not correct for biases from unmeasured variables.