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Identifying clinical scenarios that maximize the cost-effectiveness of biological treatments can lead to optimized health care cost-saving and clinical effectiveness from a society’s perspective. Dr Derek Tang and colleagues identified published articles between 1995 and 2012 in PubMed, EMBASE, ABI/INFORM, Tuft’s Cost-Effectiveness Analysis Registry Database, Cochrane National Health Service Economic Evaluation Database, International Pharmaceutical Abstracts, Web of Science, and Google Scholar. Studies of interest included cost studies, economic evaluations, or narrative or systematic reviews related to economic evaluations of biological treatments for moderate-to-severe Crohn’s disease (CD). The primary outcomes of interest included costs associated with biological treatments and cost-effectiveness measures, including incremental cost-effectiveness ratios.  | | Infliximab therapy reduced health care resource utilization and cost | | Inflammatory Bowel Diseases |
A threshold of $100,000 per quality-adjusted life year gained was used for treatment cost-effectiveness. The researchers identified 38 studies, including 15 economic evaluations and 23 cost studies or reviews of economic evaluations. Economic evaluations found that infliximab and adalimumab were more cost-effective than standard therapy for luminal CD when provided as an induction therapy followed by episodic therapy over 5 or more years. The team found that cost-effectiveness of infliximab and adalimumab versus standard therapy for luminal CD was less certain when used as 1-year maintenance treatment with or without previous induction therapy. The team noted that cost studies revealed that infliximab therapy reduced health care resource utilization and cost. Older reviews were inconclusive about the cost-effectiveness of biological treatments used for CD. Dr Tang's team concludes, "Current evidence suggests that biological treatments may be cost-effective for CD under certain clinical scenarios." "Future studies evaluating all biological treatments are needed to compare their respective benefits and costs."
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