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PTU-056 5-asa use in crohn’s remains common and is an opportunity for cost saving
  1. A Zacks,
  2. EL Johnston,
  3. S Mashari,
  4. S Anderson,
  5. JD Sanderson,
  6. PM Irving
  1. Gastroenterology, Guy’s and St Thomas’ Hospitals NHS Foundation Trust, London, UK

Abstract

Introduction The British Society of Gastroenterology,1National Institute for Health and Care Excellence,2European Crohn’s and Colitis Organisation3and the American College of Gastroenterology,4agree that there is a limited role for 5-aminosalicylic acid (5-ASA) in the treatment of Crohn’s disease (CD). Despite this, many patients with CD are still prescribed 5-ASA regularly.

Method 100 patients with CD were questioned about 5-ASA usage during routine outpatient appointments. They were asked whether they were prescribed a 5-ASA, if it was on repeat prescription, if they took it regularly or reserved it for flare-ups, and whether they perceived benefit from the drug. Finally, the consulting clinician made a clinical decision as to whether discontinuation of 5-ASA was appropriate.

Results Of the 100 patients who were surveyed, 35 (35%) were taking a 5-ASA, 18 of whom (51%) were taking Pentasa, 11 (31%) Asacol, 4 (11%) Mezavant and the remaining two (6%) were uncertain which preparation they were taking. Of patients on 5-ASA, 3 (9%) were also on biologics, 4 (11%) were on immunomodulators (IM) and 6 (17%) were on a combination of IM and biologics.

Of the 35 patients taking a 5-ASA, 20 (57.1%) were identified as candidates for cessation of treatment having taken into account patient opinion and concomitant medication as well as disease severity, site and extent. Based on current pricing, the projected annual saving for stopping 5-ASA’s in this cohort was £12,461.

Conclusion Despite 5-ASA’s no longer being recommended for the treatment of CD, 35% of patients in our cohort were taking these medications. Annual projected cost savings across our local population (Southwark and Lambeth) are £332,470.

Disclosure of interest A. Zacks Consultant for: Teva UK Limited, E. Johnston: None Declared, S. Mashari: None Declared, S. Anderson: None Declared, J. Sanderson: None Declared, P. Irving Speaker Bureau of: Warner Chilcott, Ferring, Shire, Tillott’s

References

  1. Mowat. Guidelines for the management of inflammatory bowel disease in adults. Gut2011;60:571–607

  2. National Institute for Health and Clinical Excellence. Crohn’s disease, management in adults, children and young people. London: NICE, 2012

  3. Dignass A. The second European evidence-based consensus on the diagnosis and management of Crohn’s disease: current management. J Crohn’s Colitis 2010;4:28–62

  4. Lichtenstein R. Management of Crohn’s disease in adults. Am J Gastroenterol 2009

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