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Pharmacoeconomic Review Report: sarilumab (Kevzara) [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2017 May.

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Pharmacoeconomic Review Report: sarilumab (Kevzara) [Internet].

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Table 1Cost Comparison Table of Biologic Treatments for Rheumatoid Arthritis in Adult Patients

ComparatorsStrengthDose FormPrice ($)Recommended DoseAnnual Drug Cost ($)
Sarilumab (Kevzara)150 mg/1.14 mL
200 mg/1.14 mL
Pre-filled syringe700.0000a200 mg SC every two weeks18,200
Abatacept SC (Orencia)125 mg/mLPre-filled syringe366.1000b125 mg weeklyc19,037
Abatacept IV (Orencia)250 mg/15 mLVial490.0500bPatients < 60 kg: 500 mg
Patients 60 to 100 kg: 750 mg
Patients > 100 kg: 1,000 mg
500 to 1,000 mg at weeks 0, 2, and 4 then every 4 weeks
Year 1: 20,582
Thereafter: 19,112
Adalimumab SC (Humira)40 mg/0.8 mLPre-filled syringe or pen769.970040 mg every other week20,019
Anakinra (Kineret)100 mgPre-filled syringe48.0571100 mg daily17,493
Certolizumab pegol (Cimzia)200 mg/mLPre-filled syringe664.5100400 mg at weeks 0, 2 and 4 then 200 mg every 2 weeksYear 1: 19,271
Thereafter: 17,277
Etanercept (Enbrel)25 mgVial202.930050 mg weekly or two 25 mg doses on same day every week or every 3 or 4 days21,105
50mg/mLPre-filled syringe or auto-injector405.985021,111
Entanercept (Brenzys)50 mg/mLPre-filled syringe305.0000d50 mg weekly15,860
Golimumab SC (Simponi)50 mg/0.5 mLPre-filled syringe or auto-injector1,555.1750 mg monthly18,662
Golimumab IV (Simponi)50 mg/4 mLVial849.5000b2 mg/kg at weeks 0 and 4, then every 8 weeks thereafterYear 1:17,829
Thereafter: 16,565
Infliximab (Remicade)100 mgVial987.56003 mg/kg at weeks 0, 2, and 6, then every 8 weeks thereafter

Depending on clinical response, dose can be increased to 10 mg/kg and/or up to every four weeks
Year 1: 23,701
Thereafter: 19,257
10 mg/kg every 4 weeks: $102,706 annually
Infliximab (Inflectra)100 mgVial525.0000Year 1: 12,600b
Thereafter: 10,238b
10 mg/kg every 4 weeks: $54,600 annually15
Rituximab (Rituxan)100 mg/10 mL
500 mg/50 mL
A course consists of 1,000 mg infusions at weeks 0 and 2.

Reassess for retreatment at week 26, no sooner than 16 weeks after previous
assumes 2 courses

Per course: 9,326
Tocilizumab SC (Actemra)162 mg/0.9 mLPre-filled syringe355.0000Patients < 100 kg: 162 mg SC every two weeks, increasing to weekly based on clinical response.
Patients ≥ 100 kg: 162 mg SC weekly
Every two weeks: 9,230
Weekly: 18,460
Tocilizumab IV (Actemra)80 mg/4 mL
200 mg/10mL
400 mg/20 mL
4 mg/kg every 4 weeks followed by an increase to 8 mg/kg based on clinical response4 mg/kg: 10,577b
8 mg/kg: 17,629b
Tofacitinib (Xeljanz)5 mgTablet23.55855 mg p.o. twice daily17,151

IV = intravenous; p.o. = orally; SC = subcutaneous.


Manufacturer’s submitted price.


Saskatchewan Formulary list price (January 2017).


Abatacept-naive patients require a single weight-based loading dose of 500, 750, or 1,000 mg intravenous abatacept, with weekly SC injections to start within one day thereafter, not included in cost.


IMS Quintiles Delta PA wholesale price (January 2017), also the price submitted to the CDR.23

Source: Ontario Drug Benefit Formulary or Exceptional Access Program (January 2017) list prices unless otherwise indicated. Patient weight assumed to be 75 kg. Excess medication in vials is assumed wasted. Annual period assumes 52 weeks, 26 x 2 weeks, 13 x 4 weeks, or 364 days per year.

From: Executive Summary

Copyright © 2017 Canadian Agency for Drugs and Technologies in Health.

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