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 24 February 2018

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News

Non-adherence to 5-aminosalicylic acid products influences cost of ulcerative colitis

The latest issue of the Alimentary Pharmacology & Therapeutics explores the impact of non-adherence to 5-aminosalicylic acid products on the frequency and cost of ulcerative colitis flares.

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Ulcerative colitis can be maintained in remission with 5-aminosalicylic acid medications.

However, frequent non-adherence by patients who are feeling well has been associated with more frequent flares of colitis.

Dr Higgins and colleagues from Michigan, USA performed a systematic review of the published literature and unpublished randomized clinical trials.

The trials assessed the impact of non-adherence with 5-aminosalicylic acid medications on the incidence of ulcerative colitis flares and costs of care.

The team performed a search of MEDLINE, EMBASE and the Cochrane databases.

The relative risk for flare in non-adherent vs adherent patients was 3.7
Alimentary Pharmacology & Therapeutics

Prospective studies of ulcerative colitis maintenance with 5-aminosalicylic acids in adults were selected if they included data on adherence and disease flares.

Studies using insurance claims data to estimate the impact of non-adherence on cost of care were included.

The research team obtained data from unpublished randomized clinical trials from the FDA with a request under the Freedom of Information Act.

The researchers found that the relative risk for flare in non-adherent vs adherent patients ranged from 3.7 to infinity.

Data were obtained from 6 unpublished 5-aminosalicylic acid randomized clinical trials, but none measured the impact of adherence on disease activity.

The team noted that the comorbidity-adjusted annual costs of care in adherent patients were 13% less than in non-adherent patients, despite increased medication expenditures.

Dr Higgins’ team concluded, “A substantial proportion of ulcerative colitis flares and medical costs of ulcerative colitis are attributable to 5-aminosalicylic acid non-adherence.”

“As non-adherence to 5-aminosalicylic acid medications is common, cost-effective strategies to improve adherence are needed.”

“The impact of adherence on disease activity should be measured in randomized clinical trials of all inflammatory bowel disease treatments.”

Aliment Pharmacol Ther 2009: 29(3): 247-57


06 January 2009

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