Table 3.
Baseline and follow-up healthcare resource utilization and costs for patients with CD who initiated a biologic and continued to receive it for 1 year of follow-up (as-treated population). Outpatient utilization comprised physician’s office visits and outpatient hospital and clinic visits. Pharmacy costs included costs of medication dispensed at pharmacy and administered inside the healthcare facility. Total medical costs were predominantly the sum of inpatient, ED and outpatient costsa
| Biologic | |||||||
|---|---|---|---|---|---|---|---|
| Adalimumab n=1881 | Certolizumab n=236 | Golimumab n=3 | Infliximab n=1861 | Natalizumab n=10 | Ustekinumab n=6 | Vedolizumabb n=20 | |
| Healthcare resource utilization | |||||||
| Patients with an inpatient hospitalization, n (%) | |||||||
| Baseline | 570 (30.30) | 73 (30.93) | 0 (0) | 613 (32.94) | 3 (30.00) | 3 (50.00) | 10 (50.00) |
| Follow-up | 275 (14.62) | 54 (22.88) | 0 (0) | 263 (14.13) | 0 (0) | 0 (0) | 3 (15.00) |
| Inpatient hospitalizations per patient, mean (SD) | |||||||
| Baseline | 0.43 (0.78) | 0.49 (0.89) | 0 (0) | 0.49 (0.88) | 0.30 (0.48) | 1.67 (2.25) | 0.75 (0.85) |
| Follow-up | 0.20 (0.56) | 0.38 (0.85) | 0 (0) | 0.19 (0.56) | 0 (0) | 0 (0) | 0.20 (0.52) |
| Patients with an ED visit, n (%) | |||||||
| Baseline | 775 (41.20) | 103 (43.64) | 1 (33.33) | 776 (41.70) | 5 (50.00) | 5 (83.33) | 7 (35.00) |
| Follow-up | 513 (27.27) | 71 (30.09) | 0 (0) | 534 (28.69) | 2 (20.00) | 4 (66.67) | 8 (40.00) |
| ED visits per patient, mean (SD) | |||||||
| Baseline | 0.70 (1.11) | 0.97 (2.70) | 0.33 (0.58) | 0.79 (1.33) | 0.60 (0.70) | 2.67 (2.16) | 0.70 (1.13) |
| Follow-up | 0.48 (1.15) | 0.72 (3.31) | 0 (0) | 0.47 (1.00) | 0.30 (0.67) | 0.83 (0.75) | 0.60 (0.82) |
| Patients with an outpatient visit, n (%) | |||||||
| Baseline | 1877 (99.79) | 236 (100) | 3 (100) | 1849 (99.36) | 10 (100) | 6 (100) | 20 (100) |
| Follow-up | 1868 (99.31) | 233 (98.73) | 3 (100) | 1861(100) | 10 (100) | 6 (100) | 20 (100) |
| Outpatient visits per patient, mean (SD) | |||||||
| Baseline | 16.14 (11.73) | 17.80 (12.75) | 27.00 (17.44) | 17.27 (12.84) | 19.60 (9.88) | 28.00 (15.63) | 26.30 (22.25) |
| Follow-up | 15.05 (13.00) | 17.67 (13.39) | 21.33 (7.09) | 21.94 (13.23) | 30.10 (13.53) | 36.83 (27.65) | 31.05 (22.45) |
| Costs, US$ 2015, mean (SD) | |||||||
| Inpatient hospitalization costs per patient | |||||||
| Baseline | 8894.42 (26 648.77) | 10 492.38 (29 166.85) | 0 (0) | 11 683.65 (35 928.48) | 11 534.97 (18 983.79) | 147 170.98 (285 747.82) | 12 223.66 (14 058.01) |
| Follow up | 4199.85 (17 030.25) | 8080.19 (20 565.86) | 0 (0) | 3918.12 (17 834.50) | 0 (0) | 0 (0) | 2364.72 (9008.96) |
| ED visits costs per patient | |||||||
| Baseline | 1274.60 (2779.19) | 1567.64 (3762.28) | 1342.98 (2326.11) | 1440.24 (3560.70) | 727.93 (1028.85) | 3569.68 (3046.72) | 843.65 (1465.20) |
| Follow-up | 1044.72 (4028.97) | 1170.06 (4209.37) | 0 (0) | 847.99 (2368.77) | 835.27 (1761.05) | 2093.74 (2450.65) | 1701.89 (4383.03) |
| Outpatient visits costs per patient | |||||||
| Baseline | 7803.99 (12 149.21) | 9005.12 (14 665.55) | 8373.34 (6598.27) | 17 394.02 (29 709.42) | 14 632.14 (19 283.66) | 29 120.35 (11 429.60) | 12 596.98 (14 273.08) |
| Follow-up | 4521.96 (5521.87) | 5303.72 (6673.90) | 9391.97 (6967.49) | 10 070.37 (16 781.91) | 10 592.61 (4679.90) | 7828.56 (8860.66) | 31 374.63 (20 248.29) |
| Total medical costs per patient | |||||||
| Baseline | 19 837.11 (32 052.82) | 23 518.26 (39 755.76) | 18 411.21 (21 619.98) | 32 576.31 (46 598.06) | 27 805.68 (23 835.03) | 194 206.71 (306 934.63) | 26 778.24 (21 696.95) |
| Follow-up | 10 984.94 (21 216.69) | 15 960.54 (24 596.59) | 9391.97 (6967.49) | 16 073.35 (26 619.55) | 12 653.75 (7669.55) | 10 614.10 (10 895.98) | 37 013.93 (22 603.98) |
| Pharmacy costs per patient | |||||||
| Baseline | 4798.63 (5700.39) | 6086.57 (9669.60) | 11 828.47 (8887.83) | 4162.05 (5015.65) | 23 474.93 (18 983.13) | 8210.59 (9432.24) | 7606.23 (12 849.52) |
| Follow-up | 42 141.90 (12 709.15) | 36 211.70 (12 773.02) | 53 677.88 (20 737.84) | 42 504.25 (33 689.20) | 73 353.16 (41 617.06) | 116 161.44 (40 545.36) | 44 250.79 (44 740.47) |
| Medical and pharmacy costs per patient | |||||||
| Baseline | 24 635.74 (32 763.09) | 29 604.84 (42 484.50) | 30 239.68 (13 482.39) | 36 738.35 (47 014.77) | 51 280.61 (18 410.06) | 202 417.30 (315 989.78) | 34 384.47 (29 555.64) |
| Follow-up | 53 126.84 (25 940.69) | 52 172.23 (28 908.94) | 63 069.84 (27 048.67) | 58 577.60 (43 762.09) | 86 006.90 (47 308.21) | 126 775.54 (43 885.33) | 81 264.72 (45 114.80) |
Total medical costs also included a small amount of costs from healthcare settings such as home healthcare, hospice facility, skilled nursing facility, etc., these are not reported separately;
likely vedolizumab use was identified by prescription claims for vedolizumab, claims with unclassified HCPCS code J3590 along with a primary diagnosis code for UC or CD, or claims with HCPCS codes C9026 and J3380.
CD, Crohn’s disease; ED, emergency department; HCPCS; Healthcare Common Procedure Coding System; SD, standard deviation; UC, ulcerative colitis.