Switching Biologic Treatments in Crohn Disease Linked to Increased Health Care Costs

Patients with Crohn disease (CD) who switched biologic treatments have significantly higher health care resource use and costs, according to study results presented at the American College of Gastroenterology (ACG) 2022 Annual Meeting, held from October 21 to 26, 2022, in Charlotte, North Carolina, and virtually.

Using data from the IBM MarketScan Commercial Subset from October 1, 2015, through March 31, 2020, researchers assessed the economic burden associated with switching treatment in adults with CD in the United States.

Eligible participants were newly diagnosed with CD (≥2 CD diagnoses at least 30 days apart) and were treated with a first-line biologic (prescription fill/injection) on or after their CD diagnosis. The date of the first-line biologic was the index date.

Patients were categorized as switchers or nonswitchers according to whether they had switched to another biologic or 5-aminosalicylic acid or immunomodulator during the 12-month study period after the index date. Kaplan-Meier analyses were used to estimate the mean time to treatment switch, and all-cause health care resource use and costs (2020 $US) were compiled and compared for the 2 cohorts.

A total of 4006 patients were included — 640 were classified as switchers and 3366 were nonswitchers. Their mean age was 39.5 years, and 50.9% were women. At 6 months, the rate of treatment switch was 7.1%, and at 12 months the rate was 16.0%.

The rate of prolonged corticosteroid use (≥90 days) was higher in switchers compared with nonswitchers (31.6% vs 8.2%; P <.01). In addition, switchers had higher rates of inpatient admissions (25.9% vs 12.6%; P <.01), emergency department visits (41.6% vs 35.4%; P <.01), and number of outpatient visits (22.8 vs 17.0; P <.01) compared with nonswitchers.

The total all-cause health care costs were greater in switchers vs nonswitchers ($95,689 vs $81,027; P <.01), which was primarily accounted for by higher medical costs ($24,135 vs $14,416; P <.01). Switchers aged 30 to 39 years had the highest total costs ($100,676 vs $78,265, P <.01).

“These findings suggest a potential unmet need with current treatment options and highlight the impact of switching biologics on the economic burden of patients with CD,” the study authors noted.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.