Real-world biologic treatment and associated cost in patients with inflammatory bowel disease.

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 57 296 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 (54.9 %/56.7 % female) and 42.6/37.8 years for VDZ patients (56.3 %/54.9 % female). The proportion of patients receiving a maintenance dosage > 150 % compared to SmPC was 15.1 % for Adalimumab, 5.2-39.0 % for Golimumab, 14.7-34.5 % for Infliximab, and 19.7 % for VDZ patients. During the maintenance phase, up to 58.8 % of patients received at least 1 prescription of any CS, and 41.7 %/47.1 % (anti-TNF-α/VDZ) were treated in a hospital due to IBD. The mean IBD-related direct health care cost per patient year was € 30 246 (anti-TNF-α)/ € 28 227 (VDZ) for bio-naïve patients (p = 0.288) and € 34 136 (anti-TNF-α)/ € 32 112 (VDZ) for bio-experienced patients (p = 0.011).

CONCLUSIONS:

 A substantial percentage of patients receive a high biologic dosage in the maintenance phase. Despite biologic therapy, 30-40 % receive a CS therapy and/or experience at least 1 IBD-associated hospitalization within a year, possibly indicating a remaining disease activity.

• Authors: Alina Brandes, Antje Groth, Fraence Gottschalk, Thomas Wilke, Boris A Ratsch, Hans-Dieter Orzechowski, Andreas Fuchs, Barthold Deiters, Bernd Bokemeyer
• Journal: Zeitschrift fur Gastroenterologie (Z Gastroenterol) Vol. 57 Issue 7 Pg. 843-851 (Jul 2019) ISSN: 1439-7803 [Electronic] Germany
• Vernacular Title: Behandlung und Kosten von Patienten mit CED in Deutschland.
• PMID: 31288280 (Publication Type: Journal Article)
• Copyright: © Georg Thieme Verlag KG Stuttgart · New York.

Chemical References

• Antibodies, Monoclonal, Humanized
• Biological Products
• Gastrointestinal Agents
• Tumor Necrosis Factor-alpha
• vedolizumab
• Infliximab

Topics

• Adult
• Antibodies, Monoclonal, Humanized (therapeutic use)
• Biological Products (therapeutic use)
• Colitis, Ulcerative (drug therapy, economics)
• Female
• Gastrointestinal Agents (therapeutic use)
• Humans
• Inflammatory Bowel Diseases (drug therapy, economics)
• Infliximab
• Male
• Middle Aged
• Retrospective Studies
• Tumor Necrosis Factor-alpha (antagonists & inhibitors)