Biologics in IBD Linked With Lower Surgery Costs, Corticosteroid Use, and Opioid Use

Biologics have represented a major step forward in the treatment of inflammatory bowel disease, comprising both Crohn disease (CD) and ulcerative colitis (UC). Despite their benefits, biologics are high-cost therapies, and their expense is often cited as a challenge for healthcare systems worldwide. However, research presented at this week’s ISPOR 2019 meeting sheds important light on the impact of biologics on the use of other healthcare resources.

First, a research team from Brazil shared their findings that among patients with CD, surgery costs were lower among those using biologics than among those using small-molecule drugs (azathioprine and prednisolone).¹

Using a Markov model, the investigators used a 100-patient cohort and calculated the number of surgeries undergone by the patients. They found that, on a 3-year time horizon, the total surgery-related costs for patients receiving small-molecule drugs were BRL $356,578 (approximately US $88,057).

By contrast, costs were as follows for patients receiving biologics: BRL $260,340 (approximately US $64,291) for ustekinumab, BRL $285,562 (approximately US $70,520) for adalimumab, BRL $290,246 (approximately US $71,676) for certolizumab pegol, and BRL $319,628 (approximately US $78,932) for vedolizumab.

Another study found that, among patients with UC, use of biologics is on the rise, and use of corticosteroids and opioids decreased among patients who were treated with biologics.²

The study analyzed medication use and healthcare resource utilization among patients with UC in the United States between 2007 and 2017. Adults with 1 or more UC diagnostic codes were included in the retrospective analysis of medical and pharmacy claims data.

The investigators found that, during the study period, the prevalence of biologic therapy among patients with UC rose from 1.9% to 12.5%. While overall corticosteroid use increased from 28.6% to 31.1%, among biologic users, corticosteroid use dropped from 60.5% to 47.2%. Opioid use also dropped from 53.6% to 40.3% among patients receiving biologics.

Continued collection of real-world data, say the authors, is necessary to capture changes in healthcare resource utilization, as well as cost, as the UC treatment landscape continues to evolve.

References

1. Santos MCLD, Rosim RP, Rachid ML, Fioratti C, Decimoni TC, Brunelli MJ. Surgery-related costs averted by the use of biologic drugs for the treatment of Crohn’s disease from the Brazilian private healthcare system perspective calculated through a mathematical model. Presented at: International Society for Pharmacoeconomics and Outcomes Research 24th Annual International Meeting; May 18-22, 2019; New Orleans, Louisiana. Abstract PGI9.

2. Hunter T, Farrar M, Dong Y, Choong C, Naegeli A. Medication use and healthcare resource utilization trends among adults ulcerative colitis patients in the United States—2007-2017. Presented at: International Society for Pharmacoeconomics and Outcomes Research 24th Annual International Meeting; May 18-22, 2019; New Orleans, Louisiana. Abstract PGI13.