Costs of Providing Infusion Therapy for Rheumatoid Arthritis in a Hospital-based Infusion Center Setting

Jordana Schmier, Kristine Ogden, Nancy Nickman, Michael T. Halpern, Mary Cifaldi, Arijit Ganguli, Yanjun Bao, Vishvas Garg

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


Purpose Many hospital-based infusion centers treat patients with rheumatoid arthritis (RA) with intravenous biologic agents, yet may have a limited understanding of the overall costs of infusion in this setting. The purposes of this study were to conduct a microcosting analysis from a hospital perspective and to develop a model using an activity-based costing approach for estimating costs associated with the provision of hospital-based infusion services (preparation, administration, and follow-up) in the United States for maintenance treatment of moderate to severe RA. Methods A spreadsheet-based model was developed. Inputs included hourly wages, time spent providing care, supply/overhead costs, laboratory testing, infusion center size, and practice pattern information. Base-case values were derived from data from surveys, published studies, standard cost sources, and expert opinion. Costs are presented in year-2017 US dollars. The base case modeled a hospital infusion center serving patients with RA treated with abatacept, tocilizumab, infliximab, or rituximab. Findings Estimated overall costs of infusions per patient per year were $36,663 (rituximab), $36,821 (tocilizumab), $44,973 (infliximab), and $46,532 (abatacept). Of all therapies, the biologic agents represented the greatest share of overall costs, ranging from 87% to $91% of overall costs per year. Excluding infusion drug costs, labor accounted for 53% to 57% of infusion costs. Implications Biologic agents represented the highest single cost associated with RA infusion care; however, personnel, supplies, and overhead costs also contributed substantially to overall costs (8%–16%). This model may provide a helpful and adaptable framework for use by hospitals in informing decision making about services offered and their associated financial implications.

Original languageEnglish (US)
Pages (from-to)1600-1617
Number of pages18
JournalClinical Therapeutics
Issue number8
StatePublished - Aug 2017
Externally publishedYes


  • abatacept
  • antibodies
  • arthritis
  • hospital costs
  • humanized
  • infliximab
  • monoclonal
  • rheumatoid
  • rituximab

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)


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