The Extra Burden of Infliximab Infusions in Inflammatory Bowel Disease

Abstract

Infliximab (IFX) infusions require repeated hospitalizations. The median duration of each hospitalization stay, including time for infusion and the cost for the health care system, are unknown. We assessed the extra burden of IFX infusions in inflammatory bowel disease (IBD). This was a prospective cross-sectional study enrolling all consecutive patients with IBD treated with IFX at the Nancy IBD Unit (January to March 2012). Four parameters were assessed: median travel duration, median time that patients stayed at the IBD unit, reimbursement for transport by the health care system, and impact of IFX infusions on their work. Among 137 IBD patients, 48.9% were women, 74.5% had Crohn's disease, and the median age was 35 (range, 18-65) years. The median travel duration backward and forward from home to the Nancy IBD unit was 2 (range, 0.5-4) hours. The patients stayed at the IBD unit for a median period of 4.5 (range, 2.8-6.7) hours. For 63.5% of the patients (87/137), transport was reimbursed by the health care system. Of the patients receiving IFX infusions, 10.9% (15/137) were unemployed, 24.8% (34/137) had the agreement of their employer to spend 1 day at the hospital for their IFX infusion, 27.0% (36/137) asked specifically a vacation for the IFX infusion, and 13.9% (19/137) were in sick leave. The patients spend a median of 6.5 hours outside their home for each IFX infusion, and they often take a day of vacation or rest. This represents an extra burden for IFX-treated patients and for the health care system.