Health care and cost of medication for inflammatory bowel disease in the Rhein-Main region, Germany: A multicenter, prospective, internet-based study

Abstract

The registry provides the first detailed data about the reality of treatment of IBD patients in Germany and reveals the necessity for networking among attending physicians in order to implement guidelines-conformed treatment.

Methotrexate for maintenance of remission in chronic active Crohnʼs disease

“…However, while MTX has gained wide acceptance by rheumatologists as the preferred first-line disease-modifying treatment, 26 it plays only a minor role in the management of chronic active CD. Although considered a secondline therapy various issues have limited its use in daily clinical practice, 16 in particular persistent concerns about the long-term safety of the drug.…”

“…Finally, persistent concerns about the long-term safety of the drug have limited its use by gastroenterologists, as assessed in a recent questionnaire. 15,16 In this study we report the long-term efficacy and safety profile of MTX in a series of patients at our hospital with chronic active CD resistant or intolerant of thiopurines. In addition, we carried out a meta-analysis of previously published reports including our own findings to gain a more detailed understanding of the clinical long-term efficacy of MTX in chronic active CD.…”

Health care costs and their predictors of inflammatory bowel diseases in Germany

“…Due to important changes in treatment patterns, especially with respect to available medications, the only German study relevant for a comparison is a work by Blumenstein et al [9]. Other German studies [8,[10][11][12] were all conducted previous to the introduction of Blumenstein et al [9] calculated medication costs on the basis of an internet-based survey that was conducted between November 2005 and January 2007.…”

“…Hence, the validity or accuracy might be limited due to several concerns with double-counting being one of the more prominent concerns. Furthermore, other German costs studies [8][9][10][11][12][13] analyzed only parts of the total costs or are likely to be outdated, as treatment patterns have changed during the last years (i.e. due to the introduction of biological agents).…”

Differences between Treatment Guidelines - Germany

“…A regional survey among gastroenterologists revealed the surprising result that 20% of patients treated in private practices receive mesalamine as monotherapy. Even in hospitals, 7.8% of patients receive mesalamine as monotherapy [5]. Recently, a controlled trial comparing the ‘gold standard' for remission induction budesonide with mesalamine showed both treatments to be equally effective in mild to moderate ileocecal CD [6].…”