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Canadian Journal of Gastroenterology
Volume 25, Issue 9, Pages 497-502
http://dx.doi.org/10.1155/2011/157604
Original Article

Health Care Resource Use and Costs for Crohn’s Disease before and after Infliximab Therapy

Dustin E Loomes, Christopher Teshima, Philip Jacobs, and Richard Fedorak

Division of Gastroenterology, University of Alberta, Edmonton, Alberta, Canada

Received 3 October 2010; Accepted 24 February 2011

Copyright © 2011 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

BACKGROUND: Infliximab therapy in patients with Crohn’s disease decreases resource use; however, the overall impact on health-related expenditures is unclear, especially beyond one year of study.

METHODS: A retrospective analysis of economic data one and two years before and after infliximab therapy was performed using patients who served as their own controls. Total health care resource use and direct health care costs were compared for patients with or without fistulae.

RESULTS: Patients with one (n=66) and two (n=39) years of economic data before and after infliximab treatment had their resource use and direct health care costs estimated. In the year following initiation of infliximab therapy, there were significant decreases in health care use, reflected in total hospital days (495 to 155 [P<0.05]), inpatient colonoscopies (46 to 24 [P<0.05]), outpatient colonoscopies (58 to 33 [P<0.05]) and major surgeries (10 to 2 [P<0.05]). Direct health care costs of inpatient costs for luminal (−$1,747 [P<0.05]) and fistulizing disease (−$2,530 [P<0.05]), major surgeries (−$1240 [P<0.05]) and outpatient colonoscopies (−$184 [P<0.05]) were also significantly reduced before and after infliximab therapy. Total direct health care costs, including the drug cost of infliximab, increased ($21,416 [P<0.05]). In general, the trends in health care costs analyzed over four consecutive years paralleled the two consecutive-year analysis.

CONCLUSIONS: Infliximab therapy in patients with Crohn’s disease resulted in a significant decrease in both resource use and health care costs, but an increase in total direct health care costs once the cost of infliximab was added.