Curtis JR, et al. - In the present study, the researchers tested the assumption that dose escalation of infliximab could offset the potential savings from using biosimilar infliximab, compared with the use of an alternative TNFi (golimumab) for which a biosimilar was neither available nor expected in the near future. Medicare enrollees with rheumatoid arthritis (RA) initiating infliximab or golimumab were analyzed. In total, 5,174 infliximab and 2,843 golimumab initiators have been observed. Dose escalation for golimumab was rare but common for infliximab and was even more common in patients who continued to receive treatment for infliximab. Regardless of dose escalation, the adjusted least square mean dollar amounts were significantly higher for golimumab ($28,146) compared with infliximab ($21,216) and higher for persistent patients (cost difference $9269, favoring infliximab). Despite frequent dose escalation with infliximab, which often raises the dosage by threefold or more, savings from its current biosimilar value greatly offset the cost of an alternative infused TNFi biologic for which there is no biosimilar.