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The pharmacoeconomics of biologic therapy for IBD

Nature Reviews Gastroenterology & Hepatology volume 7, pages 103–109 (2010)Cite this article

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Abstract

The past decade has been marked by the introduction and expanding use of biologic therapies for the induction and maintenance of response in patients with IBD. Although widely heralded for their efficacy, these agents have also stirred controversy over the potential economic impact that they will have upon the world's health-care systems. Traditional cost analyses had shown that IBD medication costs contributed minimally towards the overall costs associated with the disease; however, these studies were all conducted before the introduction of biologic therapies. At that time, a small minority of patients accounted for a disproportionately large percentage of the overall costs, suggesting that cost-savings could be realized if interventions decreased the utilization of health-care resources and associated costs. More recent studies have been heterogeneous in their design and findings—some have suggested that cost-savings realized due to a decrease in the utilization of health-care services may offset the higher costs of biologic agents. Incorporation of data on indirect cost-savings and quality of life improvements into ongoing and future analyses is required to allow for more accurate analyses of overall costs and cost-savings.

Key Points

  • Chronic relapsing diseases associated with a young age at onset and normal life expectancy, such as IBD, result in a lifetime accrual of disease-related costs

  • The largest contributors to the direct costs of IBD have traditionally been surgery and hospitalization

  • Biologic therapies can reduce the numbers of hospitalizations and surgeries, and the use of other resources, at least in the first 3 years of treatment

  • Over the course of their lives, patients with IBD who are ill incur substantial indirect costs to themselves and society owing to disability and loss of productivity

  • The expense of biologic therapies may be offset by their ability to decrease utilization of health-care resources and to reduce the indirect costs of IBD

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Figure 1: Percentage of total charges and total amount paid for the highest 2% of IBD patient claims in a large commercial US health insurer medical claims database.
Figure 2: Direct costs to patients with IBD in 2003–2004, from a US medical and pharmacy claims database.

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Authors and Affiliations

  1. University of Chicago Medical Center, 5841 S. Maryland Avenue, MC 4076, Chicago, 60637, IL, USA

    Russell D. Cohen

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The author is on the Speaker's Bureau for Abbott Laboratories, Axcan-Scandipharm, Elan Pharmaceuticals, Pharmatel Fresenius Kabi Pty Ltd, Proctor and Gamble Pharmaceuticals, Salix Pharmaceuticals, Shire PLC and UCB Pharma. He is also a Consultant for Abbott Laboratories, Axcan-Scandipharm, Elan Pharmaceuticals, Centocor (Johnson & Johnson), Proctor and Gamble Pharmaceuticals, Prometheus Laboratories, Salix Pharmaceuticals, Shire PLC and UCB Pharma.

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Cohen, R. The pharmacoeconomics of biologic therapy for IBD. Nat Rev Gastroenterol Hepatol 7, 103–109 (2010). https://doi.org/10.1038/nrgastro.2009.232

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