Implementable Strategies and Exploratory Considerations to Reduce Costs Associated with Anti-TNF Therapy in Inflammatory Bowel Disease

Abstract

A health care system is needed where care is based on the best available evidence and is delivered reliably, efficiently, and less expensively (best care at lower cost). In gastroenterology, anti-tumor necrosis factor (anti-TNF) agents represent the most effective medical therapeutic option for patients with moderate-to-severe inflammatory bowel disease (IBD), but are very expensive and account for nearly a quarter of the cost of IBD care, representing a major area of present and future impact in direct health care costs. The ImproveCareNow Network, consisting of over 55 pediatric IBD centers, seeks ways to improve the value of care in IBD – curtailing unnecessary costs and promoting better health outcomes through systematic and incremental quality improvement initiatives. This report summarizes the key evidence to facilitate the cost-effective use of anti-TNF agents for patients with IBD. Our review outlines the scientific rationale for initiating cost-reducing measures in anti-TNF use and focuses on three implementable strategies and four exploratory considerations through practical clinical guidelines, as supported by existing evidence. Implementable strategies can be readily integrated into today’s daily practice, while exploratory considerations can guide research to support future implementation.

Health Insurance Paid Costs and Drivers of Costs for Patients With Crohn’s Disease in the United States

“…Coincidently, due to the potent anti-infl ammatory eff ects of biologics, acute care costs associated with IBD such as hospitalizations and emergency department visits appear to be declining, as reported in our study and others. However, pharmacy utilization costs and acute care costs continue to be the primary cost drivers in the modern era of IBD medical care ( 17 ). Although our study did not account for the potential rate of rise for the costs associated with biologics, there has been a clear shift between the two cost drivers, such that pharmacy utilization outpaces acute care services.…”

Progress in the treatment and outcome of pediatric inflammatory bowel disease patients

“…Regarding the increasing burden of pediatric IBD in health care, there have been surprisingly few studies on economically oriented perspectives related to the benefits and costs of available therapeutic agents [108][109][110][111]. Carrying out a cost-benefit analysis has been hampered by more than one obstacle, most of them related to variation in practice of patient care, legislation, and possibilities to gather follow-up data (see Table 4).…”

Evaluation von Gründen für eine verzögerte Diagnosestellung von chronisch entzündlichen Darmerkrankungen

“…Doch auch die Bedeutung für das Gesundheitssystem ist nicht zu unterschätzen. In den Vereinigten Staaten von Amerika entstehen allein in der Gastroenterologie etwa 25% der Kosten allein in der Therapie von CED-Patienten mit Biologicals wie Anti-Tumor-Nekrose-Faktoren (Anti-TNFs) [30][31][32] . der Befragten im Klinikum Waldfriede in Berlin-Zehlendorf (Tab.…”