Infliximab use in Crohn's disease: impact on health care resources in the UK

  • Jewell D
  • Satsangi J
  • Lobo A
 et al. 
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Abstract

OBJECTIVE: To quantify the impact of infliximab therapy on health care resource utilization in the UK. METHODS: A retrospective audit was undertaken at seven centres in the UK, which reviewed patient notes for a period of 6 months before and 6 months after an initial infliximab infusion. Details of hospital admissions, outpatient visits, operations, diagnostic procedures, drug usage, and overall efficacy were collected. Results were compared for the two 6 month study periods. RESULTS: A total of 205 patients (62% female, median age 33 years) with moderate/severe Crohn's disease were audited. The majority of patients had chronic active disease (62%) and most received one infusion initially (72%). Clinicians rated 74% of responses as good to excellent and patients 72%. Most patients had concomitant immunosuppression (pre: 75%, post: 75%). Approximately half of the patients (45%) stopped taking steroids, with a further 34% having a dosage reduction. A fall of 1093 inpatient days was seen (1435 vs. 342) in the 6 months following infliximab administration. There were seven fewer operations, 33 fewer examinations under anaesthetic, and 99 fewer diagnostic procedures. Outpatient visits were similar pre- versus post- (555 vs. 534). The total reduction in direct costs amounted to an estimated pounds 591,006. Three hundred and fifty-three infliximab infusions were administered at an estimated cost of pounds 562,719. Thus, there was a net reduction of pounds 28,287 or pounds 137.98 per patient. CONCLUSIONS: Infliximab appears to be a potentially cost effective treatment for selected patients based on the reduced number of inpatient stays, examinations under anaesthetic, and diagnostic procedures over a 6 month period.

Author-supplied keywords

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Monoclonal/economics/*therapeutic use
  • Antirheumatic Agents/economics/*therapeutic use
  • Cost-Benefit Analysis
  • Crohn Disease/*drug therapy/economics/surgery
  • Drug Costs/statistics & numerical data
  • Epidemiologic Methods
  • Female
  • Great Britain
  • Health Care Costs/statistics & numerical data
  • Health Resources/*utilization
  • Health Services Research
  • Hospitalization/statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Treatment Outcome
  • Tumor Necrosis Factor-alpha/antagonists & inhibito

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Authors

  • D P Jewell

  • J Satsangi

  • A Lobo

  • C Probert

  • A Forbes

  • S Ghosh

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