Delays, higher costs in tocilizumab therapy add to burden of GCA patients

Significant delays occur in the initiation of tocilizumab (TCZ) therapy among patients with giant cell arteritis (GCA), reports a US study.

Additionally, patients on Medicare or Medicare Advantage plans are burdened by higher out-of-pocket costs compared with other patients.

The mean time between request and first dose for GCA patients was 43 days. In addition, the mean time between request and insurance approval was 17 days, while that between medication approval and treatment initiation was 30 days.

Notably, patients with Medicare or Medicare Advantage spent significantly more for the first month of TCZ treatment ($1,399 vs $823; p<0.01) and had significantly higher rates of copay assistance (p<0.01) and full coverage of medication by the drug manufacturer or foundation (p=0.04).

“These delays and costs are excessive for a vulnerable population with a potentially disabling disease,” the authors said. “Further research is needed to investigate causes of delays, the high cost of medication, and effects on clinical outcomes.”

This study included 82 patients with GCA at the University of Washington prescribed subcutaneous TCZ between 2017 and 2024. 

The authors compared the time from medication request to medication approval/start and cost of TCZ by insurance payor using 1-way ANOVA. They also compared the use of copay assistance, prior authorization requirement, drug manufacturer/foundation medication coverage, and switches to intravenous TCZ by insurance using Pearson chi-square or Fisher exact tests.