Real-world biologic treatment and associated cost in patients with inflammatory bowel disease.
Z Gastroenterol
; 57(7): 843-851, 2019 Jul.
Article
en En
| MEDLINE
| ID: mdl-31288280
ABSTRACT
OBJECTIVES:
This study aimed to describe biologic treatment of German inflammatory bowel disease (IBD) patients, including biologics' dosage, health care resource use, and treatment-associated cost.METHODS:
In this retrospective claims data analysis, all continuously insured adult IBD patients (Crohn's disease [CD] or ulcerative colitis [UC]) who started a new therapy with an anti-tumor necrosis factor alpha (anti-TNF-α) or vedolizumab (VDZ) were included. Observation started with the date of the first prescription of index biologic therapy and lasted 12 months.RESULTS:
In the database, 1248 out of 57â296 IBD patients started a biologic treatment of interest (1020 anti-TNF-α, 228 VDZ), and 837 patients were bio-naïve (773 anti-TNF-α, 64 VDZ). The mean age of bio-naïve/bio-experienced anti-TNF-α patients was 39.2/38.1 years (54.9â%/56.7â% female) and 42.6/37.8 years for VDZ patients (56.3â%/54.9â% female). The proportion of patients receiving a maintenance dosage >â150â% compared to SmPC was 15.1â% for Adalimumab, 5.2-39.0â% for Golimumab, 14.7-34.5â% for Infliximab, and 19.7â% for VDZ patients. During the maintenance phase, up to 58.8â% of patients received at least 1 prescription of any CS, and 41.7â%/47.1â% (anti-TNF-α/VDZ) were treated in a hospital due to IBD. The mean IBD-related direct health care cost per patient year wasââ30â246 (anti-TNF-α)/ââ28â227 (VDZ) for bio-naïve patients (pâ=â0.288) andââ34â136 (anti-TNF-α)/ââ32â112 (VDZ) for bio-experienced patients (pâ=â0.011).CONCLUSIONS:
A substantial percentage of patients receive a high biologic dosage in the maintenance phase. Despite biologic therapy, 30-40â% receive a CS therapy and/or experience at least 1 IBD-associated hospitalization within a year, possibly indicating a remaining disease activity.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Productos Biológicos
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Fármacos Gastrointestinales
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Enfermedades Inflamatorias del Intestino
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Colitis Ulcerosa
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Factor de Necrosis Tumoral alfa
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Anticuerpos Monoclonales Humanizados
Tipo de estudio:
Health_economic_evaluation
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Observational_studies
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Risk_factors_studies
Límite:
Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Z Gastroenterol
Año:
2019
Tipo del documento:
Article
País de afiliación:
Alemania