“We're using the same tools that demonstrate the benefit of our drugs to show that the long-term cost of steroids has been vastly underestimated.”
Glenn Philips, PhD is the Vice President of Health Economics and Outcomes Research at pharmaceutical company Argenx. Dr Philips trained as a clinical psychologist with a specialization in research design and statistics. He has held senior positions in various pharmaceutical and biotechnology companies, including Argenx, Rhythm Pharmaceuticals Inc., Akcea Therapeutics, and Biogen. His expertise lies in leading research projects, designing and analyzing clinical trials, and representing the unique needs of health outcomes in drug development efforts.
During Dr Philips’ more than two decades of pharmaceutical industry experience, he continued to run into patients who were treated with steroids and observed the negative side effects that those patients experienced.
“For many autoimmune conditions, steroids have been the only treatment available, and even when disease-specific treatments become available, displacing steroids as the standard of care proves a significant challenge.”
Dr Philips continues by explaining that payers often perceive steroids as almost free and that what excites him is a new health economic project at Argenx focused on uncovering the true cost of healthcare treatments for payers and patients and even whole economies.
“Getting a handle on the negative costs of steroids has been so hard that, at Argenx, we decided patients couldn't wait for payers and regulators and that we needed to do this for them ourselves.
There's a lot of talk about the long-term costs of steroid exposure, but nobody's ever really done a very good job of showing or determining what those costs look like - and that’s because there are so many side effects that then have additional long term costs that make it difficult to do. At Argenx, we're undertaking an effort to do just that.
When you put a patient on steroids, they often have to take them for six months or a year. What we are seeing is that many will develop diabetes or osteoporosis. For side effects that aren't reversible, patients then have to be treated for those conditions as well!”
Dr Philips believes that there is an appropriate use of steroids for short-term symptom control, but the long-term use comes with too many costs that are not considered or perhaps even seen by the clinicians. This is a systemic impact for which change really needs to start at the top with the policymakers that set prescribing and training guidelines.
“We need payers to recognize the true costs associated with steroids and that if patients are on these drugs for a long time, there will be predictable costs associated with them. Everybody recognizes the side effects, but to date, efforts to quantify the costs to better guide how they are used have been limited.”
He cites recent work presented at ISPOR that uses the GTI-MD in an effort to quantify the risk-to-benefit ratio of glucocorticoids for patients with myasthenia gravis. Even with data in place, Dr Philips believes that systemic change will take time and likens it to the shift in approach to the prescription of antibiotics.
“We need training programs to say, ‘We've got to stop using steroids for long-term illness. The data we are seeing show they are fine for short periods for intense symptoms, but you have to get patients off of them as quickly as possible.
And that's where the real change will come–when the training programs start to recognize and make a shift in how they teach people to use these powerful but potentially toxic drugs. This is the sort of change that takes a long time, it isn't something that happens overnight and the sooner we can start shifting prescribing patterns the better.”
Read more about quantifying the harms of steroid-toxicity
