A retrospective analysis of treatment patterns, drug discontinuation and healthcare costs in Crohn's disease patients treated with biologics
Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved..
BACKGROUND/AIMS: This real-world analysis evaluated the persistence and direct healthcare costs of Crohn's Disease (CD) patients treated with biologics in Italy.
METHODS: A retrospective analysis on administrative databases of Italian healthcare entities, covering 10.4 million residents, was performed. Adult CD patients under biologics between 2015 and 2020 were included and attributed to first/second treatment line based on absence/presence of biologic prescriptions 5-years before index-date (first biologic prescription).
RESULTS: Of 16,374 CD patients identified, 1,398 (8.5%) were biologic-treated: 1,256 (89.8%) in first line and 135 (9.7%) in second line. Kaplan-Meier curves estimated a higher persistence for ustekinumab-treated patients followed by vedolizumab, infliximab and adalimumab, in both lines. Considering baseline variables and adalimumab as reference, infliximab in first line (HR: 0.537) and ustekinumab in first (HR: 0.057) and second line (HR: 0.213) were associated with significantly reduced risk of drug-discontinuation. First line total/average healthcare direct-costs were €13,637, €11,201, €17,104 and €18,340 in patients persistent on adalimumab, infliximab, ustekinumab and vedolizumab, respectively.
CONCLUSIONS: This real-world analysis showed differences in persistence over 12-months between biologic treatments, being higher in ustekinumab-treated group, followed by vedolizumab, infliximab and adalimumab. Patients' management was associated with comparable direct healthcare costs among treatment lines, mainly driven by drug-related expenses.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:55 |
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| Enthalten in: |
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver - 55(2023), 9 vom: 20. Sept., Seite 1214-1220 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Degli Esposti, Luca [VerfasserIn] |
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| Links: |
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| Themen: |
Adalimumab |
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| Anmerkungen: |
Date Completed 28.08.2023 Date Revised 03.10.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.dld.2023.04.010 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM356043282 |
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| 041 | |a eng | ||
| 100 | 1 | |a Degli Esposti, Luca |e verfasserin |4 aut | |
| 245 | 1 | 2 | |a A retrospective analysis of treatment patterns, drug discontinuation and healthcare costs in Crohn's disease patients treated with biologics |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
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| 500 | |a Date Completed 28.08.2023 | ||
| 500 | |a Date Revised 03.10.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved. | ||
| 520 | |a BACKGROUND/AIMS: This real-world analysis evaluated the persistence and direct healthcare costs of Crohn's Disease (CD) patients treated with biologics in Italy | ||
| 520 | |a METHODS: A retrospective analysis on administrative databases of Italian healthcare entities, covering 10.4 million residents, was performed. Adult CD patients under biologics between 2015 and 2020 were included and attributed to first/second treatment line based on absence/presence of biologic prescriptions 5-years before index-date (first biologic prescription) | ||
| 520 | |a RESULTS: Of 16,374 CD patients identified, 1,398 (8.5%) were biologic-treated: 1,256 (89.8%) in first line and 135 (9.7%) in second line. Kaplan-Meier curves estimated a higher persistence for ustekinumab-treated patients followed by vedolizumab, infliximab and adalimumab, in both lines. Considering baseline variables and adalimumab as reference, infliximab in first line (HR: 0.537) and ustekinumab in first (HR: 0.057) and second line (HR: 0.213) were associated with significantly reduced risk of drug-discontinuation. First line total/average healthcare direct-costs were €13,637, €11,201, €17,104 and €18,340 in patients persistent on adalimumab, infliximab, ustekinumab and vedolizumab, respectively | ||
| 520 | |a CONCLUSIONS: This real-world analysis showed differences in persistence over 12-months between biologic treatments, being higher in ustekinumab-treated group, followed by vedolizumab, infliximab and adalimumab. Patients' management was associated with comparable direct healthcare costs among treatment lines, mainly driven by drug-related expenses | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Drug persistence | |
| 650 | 4 | |a Healthcare costs | |
| 650 | 4 | |a Real-world evidence | |
| 650 | 7 | |a Adalimumab |2 NLM | |
| 650 | 7 | |a FYS6T7F842 |2 NLM | |
| 650 | 7 | |a Infliximab |2 NLM | |
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| 650 | 7 | |a Ustekinumab |2 NLM | |
| 650 | 7 | |a FU77B4U5Z0 |2 NLM | |
| 650 | 7 | |a Biological Products |2 NLM | |
| 700 | 1 | |a Daperno, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a Dovizio, Melania |e verfasserin |4 aut | |
| 700 | 1 | |a Franchi, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Sangiorgi, Diego |e verfasserin |4 aut | |
| 700 | 1 | |a Savarino, Edoardo Vicenzo |e verfasserin |4 aut | |
| 700 | 1 | |a Scaldaferri, Franco |e verfasserin |4 aut | |
| 700 | 1 | |a Secchi, Ottavio |e verfasserin |4 aut | |
| 700 | 1 | |a Serra, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Perrone, Valentina |e verfasserin |4 aut | |
| 700 | 1 | |a Armuzzi, Alessandro |e verfasserin |4 aut | |
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