Activity-based costing and budget analysis of vedolizumab versus conventional treatments in ulcerative colitis and Crohn's disease

Abstract

Objective: To assess the organizational impact of the introduction of vedolizumab compared to the biotechnological anti-TNF alternatives to date available in Italy for the management of Ulcerative Colitis (UC) and Crohn's Disease (CD). Methods: A questionnaire aimed at acquiring data about the Italian real practice concerning the management of patients affected by UC and CD was administered to a panel of expert clinicians from three Italian centers of excellence. The determination of the cost of the therapies was realized through an Activity-Based Costing (ABC) analysis which identified the differential between the use of vedolizumab and the alternatives. Results: The reduced time of infusion of vedolizumab allows a total cost/infusion of (sic)97.89, with savings vs. infliximab of (sic)39.60 (UC and CD). Vedolizumab implies an expenditure of (sic)17,229.84 (UC) and (sic)17,459.63 (CD) in the first year which allows, compared to Infliximab originator ((sic)17,739.60), a saving/patient of (sic)509.76 and (sic)279.97 for UC and CD respectively. In the following years, vedolizumab implies an expenditure of (sic)13,870.55 and (sic)14,049.95 for UC e CD, lower than infliximab ((sic)14,284.73), with a differential of (sic)414.18 for UC and (sic)234.78 for CD. In the comparison with infliximab biosimilar, the results are the same with regard to the administration costs, but the combined cost administration + drug is lower than that of vedolizumab due to the lower expenditure for drugs. Conclusions: Vedolizumab implies a reduction of the time spent by the professionals involved in the provision of the treatment, allowing a reallocation of the saved resources.