Evaluation of economic burden with biologic treatments in Crohn’s disease patients: A mirror image study using an insurance database in Japan

Abstract

Biologics are recommended in Japan to treat moderate to severe Crohn’s Disease (CD). Although CD is associated with high direct costs in Japan, updated information after ustekinumab’s approval is unavailable. We aimed to evaluate the healthcare resource utilization (HRU) and associated direct costs from the payer’s perspective in Japan. Claims data (2010–2018) were retrospectively analyzed to identify patients with CD. HRU and associated costs were evaluated for 12 months before and after biologic initiation and followed-up till 36 months post-initiation. Outcomes were reported using descriptive statistics. Among the included patients (n = 3,496), 1,783 were on biologics and 1,713 were on non-biologics. Mean (SD) age was 36.4 (13.2) years and patients were predominantly male (76.1%). Patients aged 18–39 years were affected with CD the most (55.3%). Biologic initiation was associated with a reduction in inpatient stay, length of stay, outpatient visits, and associated costs; and an increase in pharmacy costs and total costs after 12 months. Extended follow-up showed a decreasing trend in HRU and costs till 24 months but an increase after 36 months. These findings demonstrated reduction in clinical burden and slight increase in economic burden with biologics. However, indirect costs also need to be evaluated.

Medical management of pediatric inflammatory bowel disease in the Asia‐Pacific region: A position paper by the Asian Pan‐Pacific Society for Pediatric Gastroenterology, Hepatology, and Nutrition (APPSPGHAN) PIBD Working Group

“…The proportion of adult patients with IBD under treatment with anti-tumor necrosis factor (anti-TNF) in Asia differs markedly, from as high as 40% in Japan (in 2021) to as low as 10% in Malaysia (in 2019). 81,82 A study on pediatric IBD from India reported that biologics were used in 18% of children with an onset <16 years. 83 Data on the use of other biologics such as golimumab, 84 ustekinumab, 85,86 vedolizumab, 87 and tofacitinib in childhood IBD in Asia are lacking.…”

Crohn’s disease and short bowel syndrome

“…In Japan, biologics are recommended to treat moderate-to-severe CD. A mirror image study using an insurance database showed that 51% of patients with CD are on biologics [ 3 ].…”