Real‐world assessment of therapy changes, suboptimal treatment and associated costs in patients with ulcerative colitis or Crohn's disease

• DOI: 10.1111/apt.12727
• Publication Date: 2014-04-04T02:08:42Z
• Authors: D. T. Rubin; R. Mody; K. L. Davis; C.‐C. Wang
• Keywords: Discontinuation

Summary Background Treatments for Crohn's disease ( CD ) and ulcerative colitis UC are not uniformly effective, thus necessitating dose changes, switching, augmentation carry adverse event risk, often requiring discontinuation, which reduces treatment benefits. Aim To assess continuity of changes to initial treatments, as well costs associated with specific parameters defining suboptimal therapy. Methods Commercial US insurance claims (2006–2010) were retrospectively analysed. patients receiving monotherapy 5‐aminosalicylates (5‐ ASA s), corticosteroids CS ), immunomodulators IM or biologics included. Continuity (index) therapy (2011 $) assessed over 12 months following initiation. Suboptimal included discontinuation switch (except escalation, augmentation, inadequate loading (biologics only), prolonged use (>3 months), surgery hospitalisation. Results The study 13 005 19 878 patients. Augmentation was a common index change (~20% 5‐ initiators, ~40% ≥40% initiators 26–55% biologic initiators) in both Approximately 50% discontinued/interrupted treatment. 80% had ≥1 marker. Mean all‐cause total per patient significantly higher those vs. without ($18 736 $10 878; P < 0.001); , the disparity smaller ($12 679 $9653; 0.001). Conclusions Frequent observed all classes treatments. economic impact among is substantial.