737 Economic Burden of Biologic Treatment in Patients With Inflammatory Bowel Disease in the U.S.

Abstract

INTRODUCTION: Inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), is a chronic relapsing condition. IBD treatment has shifted from symptom management with corticosteroids to biologics aimed at achieving clinical remission. Patients refractory to first-line biologics are candidates for second and third-line agents. In this study, we explore the economic burden of IBD in the USA among patients initiating treatment with a biologic, and we examine whether this differs in relation to receipt of additional biologics during follow-up. METHODS: Using the IQVIATM Real-World Data Adjudicated Claims Database – US, we identified adults (≥18 years) with CD or UC and evidence of receipt of ≥1 IBD-related biologic from January 1, 2011 through December 31, 2017. Date of therapy initiation was designated the index date. Persons with <12 months of continuous data prior to index date or previous receipt of a biologic were excluded. Biologic use was examined from index date to date of IBD-related surgery, receipt of another biologic or end of study period, whichever came first. Total healthcare, outpatient and inpatient costs, prior to index date and during follow-up, were examined using Kaplan–Meier Sample Average methods and least-squares means. RESULTS: A total of 8071 patients with CD and 4832 with UC were identified. Of the patients with CD, 1028 received ≥1 additional biologic during follow-up (Multiple Biologic Cohort), while 7043 did not (Single Biologic Cohort). Corresponding counts for patients with UC were 843 and 3989, respectively. While total healthcare costs were similar for Multiple and Single Biologic Cohorts in the 12 months preceding the index date, mean (SD) total quarterly healthcare costs over 20 quarters post index date were significantly higher for the former group (CD: US$13,262 [15,463] vs US$10,902 [12,798]; P < 0.001; UC: US$14,313 [16,967] vs US$11,433 [13,387]; P < 0.001; Multiple and Single Biologic Cohorts respectively; Figures 1 and 2). Mean total quarterly inpatient and outpatient costs for patients with CD and UC post index date were also significantly higher in the Multiple compared with the Single Biologic Cohort. CONCLUSION: The level of healthcare utilization and costs post index date were significantly higher for patients with IBD who received more than one biologic during follow-up compared to those who did not.