Article Text


Inflammation bowel disease I
Comparison of medical costs among patients using adalimumab and infliximab: a retrospective study (compairs)
  1. D A Sussman1,
  2. N Kubiliun1,
  3. J Chao *2,
  4. P M Mulani2,
  5. C A Gillis2,
  6. M Yang2,
  7. M Lu3,
  8. M T Abreu1
  1. 1University of Miami, Miami, FL, USA
  2. 2Abbott Laboratories, Abbott Park, IL, USA
  3. 3Analysis Group, Inc., Boston, MA, USA


Introduction Anti-tumour necrosis factor (anti-TNF) medications have never been compared in a direct fashion under real-world circumstances. The purpose of this study was to compare healthcare utilisation and costs using insurance data for patients with Crohn's disease (CD) who newly initiated anti-TNF therapy with adalimumab (ADA) or infliximab (IFX).

Methods Patients with ≥2 diagnoses of CD (ICD-9-CM: 555.XX) who initiated ADA or IFX therapy between January 2000 and March 2009 were identified from the Medstat MarketScan database. Patients had to be continuously enrolled at least 6 months before and after anti-TNF initiation. Patients with prior biologic therapy (ie, anti-TNF or natalizumab) or colitis (ICD-9-CM: 556.x) were excluded. ADA and IFX groups were matched 1:1 using a propensity score stratified by age, residence, inpatient visit utilisation and steroid use at baseline. The primary endpoint was 6-month direct cost of healthcare. The secondary endpoints compared healthcare utilisation between groups.

Results After propensity matching, demographic, clinical and healthcare utilisation characteristics were similar between the ADA (n=623) and IFX (n=623) groups at baseline. During the 6-month interval following anti-TNF initiation, healthcare costs were significantly lower for ADA compared with IFX therapy (table 1).

All-Cause, ADA (n=623)All-Cause, IFX (n=623)CD-Relateda, ADA (n=623)CD-Relateda, IFX (n=623)
Anti-TNF drug costs10 70912 401
Other prescription drug costs1334b1639546857
Total medical service–related costs6842b10 3165199b9059
Total healthcare costs (costs excluding anti-TNF agents)18 885b (8176b)24 355 (11 955)16 454b (5745b)22 316 (9916)
  • a Based on diagnosis of CD or related comorbidities (eg, malnutrition, anaemia, abdominal symptoms, etc).

  • b p<0.0005 vs IFX.

  • c Medical costs other than hospitalisation and outpatient visits are not shown.

  • Table 1

    PWE-026 Mean HealthCare Costs (Per Person) During the 6 Months After Initiating Anti-TNF Therapy (US $)

    Both all-cause and CD-related hospitalisation decreased for both ADA and IFX groups (not shown). Emergency department (ED) use and hospitalisation in the 6-month follow-up period were similar between groups.

    Conclusion In this real-world analysis of patients with CD who newly initiated with ADA or IFX, ADA-treated patients had significantly lower healthcare costs. Hospitalisation and ED utilisation were similar between groups.

    • Crohn's disease
    • healthcare costs
    • TNF-alpha inhibitors

    Statistics from


    • Competing interests D. Sussman: None Declared, N. Kubiliun: None Declared, J. Chao Shareholder with: Abbott, Employee of: Abbott, P. Mulani Shareholder with: Abbott, Employee of: Abbott, C. Gillis Shareholder with: Abbott, Employee of: Abbott, M. Yang Shareholder with: Abbott, Employee of: Abbott, M. Lu Employee of: Analysis Group; under contract with Abb., M. Abreu Consultant for: Abbott, Amgen, Elan, Opson, Prometheus, Salix, UCB

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