Ulcerative Colitis Treatment Patterns and Cost of Care

• DOI: 10.1016/j.jval.2017.02.005
• Publication Date: 2017-03-22T09:16:44Z
• Authors: Kyle D. Null; Yihua Xu; Margaret K. Pasquale; Chinyu Su; Amy Marren; James Harnett; Jack Mardekian; Alireza Manuchehri; Paul Healey
• Keywords: Adult; Male; Time Factors; Anti-Inflammatory Agents; Cohort Studies; 03 medical and health sciences; 0302 clinical medicine; Gastrointestinal Agents; Humans; Aged; Retrospective Studies; Tumor Necrosis Factor-alpha; Health Policy; Public Health, Environmental and Occupational Health; Adalimumab; Health Care Costs; Middle Aged; Infliximab; 3. Good health; Hospitalization; Colitis, Ulcerative; Female

To examine treatment patterns, dosing, health care resource utilization, and cost of tumor necrosis factor inhibitors (TNFi), adalimumab (ADA) infliximab (IFX), among patients enrolled in US Humana insurance plans who have been diagnosed with ulcerative colitis (UC).This retrospective cohort study identified the first pharmacy or medical claim for ADA IFX (from January 1, 2007, to December 31, 2014) continuous enrollment 6 months more preindex 12 postindex, one UC diagnosis pre- postindex. TNFi discontinuation was defined as a therapy gap 56 days 112 IFX. switch nonindex initiation. Health utilization costs were characterized quarterly according patterns.The population comprised 295 patients: mean age 50.9 years, 50.5% females, 61.7% southern United States. At index date, 17% received 83% Treatment observed 52% 45% users through postindex (mean time 19 22 weeks, respectively). Among discontinuers, 46% 68% did not restart/switch TNFi. showed times 18 30 respectively. discontinuers had lowest total ($3,935) versus initiated/switched ($15,004). Nevertheless, higher UC-related hospitalization receiving therapy.Approximately half discontinued, approximately restarting/switching therapies. Further investigation patterns outcomes after is required.