PMID- 31562607
OWN - NLM
STAT- MEDLINE
DCOM- 20200617
LR  - 20231014
IS  - 1865-8652 (Electronic)
IS  - 0741-238X (Print)
IS  - 0741-238X (Linking)
VI  - 36
IP  - 11
DP  - 2019 Nov
TI  - Analysis of Safety, Medical Resource Utilization, and Treatment Costs by Drug 
      Class for Management of Inflammatory Bowel Disease in the United States Based on 
      Insurance Claims Data.
PG  - 3079-3095
LID - 10.1007/s12325-019-01095-1 [doi]
AB  - INTRODUCTION: Conventional pharmaceutical interventions for inflammatory bowel 
      disease (IBD) provide limited disease/symptom control and are associated with an 
      increased risk of adverse events (AEs). These limitations increase patient 
      morbidity, medical resource utilization (MRU), and costs. METHODS: The IQVIA 
      Real-World Data Adjudicated Claims-US database was leveraged to identify adult 
      patients (> 18 years) with Crohn's disease (Crohn's) or ulcerative colitis (UC), 
      who were new and chronic users (>/= 60 days) of oral corticosteroids (OCS), 
      immunosuppressants (IS), anti-tumor necrosis factor agents (anti-TNF) or 
      combinations thereof. Using aminosalicylate-treated patients as a reference, we 
      compared AE incidence, MRU, and medical costs across drug classes. RESULTS: The 
      analysis included 30,676 patients (Crohn's: n = 14,528; UC: n  = 16,148). OCS 
      monotherapy was the strongest predictor of any AE occurring [Crohn's: hazard 
      ratio 1.62 (1.51-1.73); UC: hazard ratio 1.57 (1.49-1.66)]. A similar pattern was 
      observed for severe infection and bone-related conditions. Patients with UC or 
      Crohn's receiving OCS or IS plus OCS were more likely to have emergency 
      department visits, IBD-related hospitalizations/visits/procedures, and 
      gastrointestinal surgery than were patients receiving other therapies. Annualized 
      total medical costs (pharmacy plus hospital service costs) were greatest for 
      anti-TNF plus IS or anti-TNF therapy in both Crohn's and UC. Annualized medical 
      service costs (excluding IBD drug costs) were highest for patients initiating 
      OCS-containing therapies [Crohn's: OCS, $27,041 (24,882-29,200) and OCS plus IS, 
      $23,332 (19,889-26,775); UC: OCS, $19,659 (17,977-21,340)]. CONCLUSION: Although 
      biologic therapies have higher pharmacy costs, treatment decisions should 
      consider the increased AE risks and long-term MRU costs associated with chronic 
      use of OCS-containing therapies. FUNDING: This study was funded by F. Hoffmann-La 
      Roche Ltd. The journal's Rapid Service Fee and Open Access publication were paid 
      for by ApotheCom on behalf of Genentech, a member of the Roche group who funded 
      the study.
FAU - Long, Grainne H
AU  - Long GH
AD  - Roche Pharmaceuticals Ltd., Real World Data Science, Hertfordshire, UK.
FAU - Tatro, Amanda R
AU  - Tatro AR
AD  - Genentech, Inc., South San Francisco, CA, USA.
FAU - Oh, Young S
AU  - Oh YS
AD  - Genentech, Inc., South San Francisco, CA, USA.
FAU - Reddy, Sheila R
AU  - Reddy SR
AD  - Partnership for Health Analytic Research, Beverly Hills, CA, USA.
FAU - Ananthakrishnan, Ashwin N
AU  - Ananthakrishnan AN
AD  - Massachusetts General Hospital, Boston, MA, USA. 
      aananthakrishnan@mgh.harvard.edu.
AD  - Harvard Medical School, Boston, MA, USA. aananthakrishnan@mgh.harvard.edu.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20190927
PL  - United States
TA  - Adv Ther
JT  - Advances in therapy
JID - 8611864
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (Immunosuppressive Agents)
MH  - Adrenal Cortex Hormones/therapeutic use
MH  - Adult
MH  - Colitis, Ulcerative/drug therapy/economics
MH  - Crohn Disease/drug therapy/economics
MH  - Female
MH  - Health Care Costs
MH  - Health Resources
MH  - Hospitalization/*economics
MH  - Humans
MH  - Immunosuppressive Agents/therapeutic use
MH  - Inflammatory Bowel Diseases/*drug therapy/*economics
MH  - Male
MH  - Middle Aged
MH  - Treatment Outcome
MH  - United States
PMC - PMC6822802
OTO - NOTNLM
OT  - Aminosalicylates
OT  - Annualized medical cost
OT  - Anti-tumor necrosis factor alpha
OT  - Claims database
OT  - Corticosteroids
OT  - Crohn's disease
OT  - Gastroenterology
OT  - Healthcare resource utilization
OT  - Ulcerative colitis
EDAT- 2019/09/29 06:00
MHDA- 2020/06/18 06:00
PMCR- 2019/09/27
CRDT- 2019/09/29 06:00
PHST- 2019/04/12 00:00 [received]
PHST- 2019/09/29 06:00 [pubmed]
PHST- 2020/06/18 06:00 [medline]
PHST- 2019/09/29 06:00 [entrez]
PHST- 2019/09/27 00:00 [pmc-release]
AID - 10.1007/s12325-019-01095-1 [pii]
AID - 1095 [pii]
AID - 10.1007/s12325-019-01095-1 [doi]
PST - ppublish
SO  - Adv Ther. 2019 Nov;36(11):3079-3095. doi: 10.1007/s12325-019-01095-1. Epub 2019 
      Sep 27.