Economic impact of combination therapy with infliximab plus azathioprine for drug-refractory Crohn's disease: A cost-effectiveness analysis

Journal of Crohn's and Colitis

Volumn 7, Issue 2, 2013, Pages 167-174

  Saito, Shota ^a   Shimizu, Utako ^a   Nan, Zhang ^a   Mandai, Nozomu ^a   Yokoyama, Junji ^b   Terajima, Kenshi ^b   Akazawa, Kouhei ^b  

^a NIIGATA UNIVERSITY GRADUATE SCHOOL OF MEDICAL AND DENTAL SCIENCES   (Japan)

^b NIIGATA UNIVERSITY MEDICAL AND DENTAL HOSPITAL   (Japan)

Author keywords

Azathioprine; Combination therapy; Cost effectiveness; Crohn's disease; Infliximab; Lymphoma

Indexed keywords

ANTIBIOTIC AGENT; AZATHIOPRINE; CORTICOSTEROID; IMMUNOMODULATING AGENT; INFLIXIMAB; MESALAZINE;

ARTICLE; COST EFFECTIVENESS ANALYSIS; CROHN DISEASE; DECISION TREE; DRUG EFFICACY; ECONOMIC ASPECT; HUMAN; MONOTHERAPY; PRIORITY JOURNAL; QUALITY OF LIFE; QUALITY OF LIFE INDEX; REMISSION; SENSITIVITY ANALYSIS; TREATMENT RESPONSE;

ANTI-INFLAMMATORY AGENTS, NON-STEROIDAL; ANTIBODIES, MONOCLONAL; AZATHIOPRINE; COST-BENEFIT ANALYSIS; CROHN DISEASE; DECISION TREES; DRUG THERAPY, COMBINATION; HUMANS; IMMUNOSUPPRESSIVE AGENTS; MODELS, ECONOMIC; QUALITY-ADJUSTED LIFE YEARS;

EID: 84872433253     PISSN: 18739946     EISSN: 18764479     Source Type: Journal    
DOI: 10.1016/j.crohns.2012.04.007     Document Type: Article

References (28)

1. Cosnes J., Gower-Rousseau C., Seksik P., et al. Epidemiology and natural history of inflammatory bowel diseases. Gastroenterology 2011, 140(6):1785-1794.
2. Hanauer S.B., Feagan B.G., Lichternstein G.R., et al. Maintenance infliximab for Crohn's disease. The ACCENT 1 randomised trial. Lancet 2002, 359:1541-1549.
3. Colombel J.F., Rutgeerts P., Renisch W., et al. SONIC study group. Infliximab, azathioprine, or combination therapy for Crohn's disease. N Engl J Med 2010, 362:1383-1395.
4. Beaugerie L., Brousse N., Bouvier A.M., et al. Lymphoproliferative disorders in patients receiving thiopurines for inflammatory bowel disease: a prospective observational cohort study. Lancet 2009, 374:1617-1625.
5. Kandiel A., Fraser A.G., Korelitz B.I., et al. Increased risk of lymphoma among inflammatory bowel disease patients treated with azathioprine and 6-mercaptopurine. Gut 2005, 54:1121-1125.
6. Jaisson-Hot I., Flourie B., Descos L., Colin C. Management for severe Crohn's disease: a lifetime cost-utility analysis. Int J Technol Assess Health Care 2004, 20:274-279.
7. Kaplan G.G., Hur C., Korzenik J., Sands B.E. Infliximab dose escalation vs. initiation of adalimumab for loss of response in Crohn's disease: a cost-effectiveness analysis. Aliment Pharmacol Ther 2007, 26:1509-1520.
8. Lindsay J., Punekar Y.S., Morris J., et al. Health-economic analysis: cost-effectiveness of scheduled maintenance treatment with infliximab for Crohn's disease-modeling outcomes in active luminal and fistulizing disease in adults. Aliment Pharmacol Ther 2008, 28:76-87.
9. Bodger K., Kikuchi T., Hughes D. Cost-effectiveness of biological therapy for Crohn's disease: Markov cohort analyses incorporating United Kingdom patient-level cost data. Aliment Pharmacol Ther 2009, 30:265-274.
10. Punekar Y.S., Sunderland T., Hawkins N., Lindsay J. Cost-effectiveness of scheduled maintenance treatment with infliximab for pediatric Crohn's disease. Value Health 2010, 13(2):188-195.
11. Miheller P., Lakatos P.L., Horváth G., et al. Efficacy and safety of infliximab induction therapy in Crohn's Disease in Central Europe-a Hungarian nationwide observational study. BMC Gastroenterol 2009, 9:66. 10.1186/1471-230X-9-66.
12. Lemann M., Mary J.Y., Duclos B., et al. Infliximab plus azathioprine for steroiddependent Crohn's disease patients: a randomised, placebo-controlled trial. Gastroenterology 2006, 130:1054-1061.
13. Hamzaoglu H., Cooper J., Alsahli M., et al. Safety of infliximab in Crohn's disease: a large single-center experience. Inflamm Bowel Dis 2010, 16(12):2109-2116.
14. Siegel C.A., Hur C., Korzenik J.R., et al. Risk and benefits of infliximab for the treatment of Crohn's disease. Clin Gastroenterol Hepatol 2006, 4:1017-1024.
15. Pearson D.C., May G.R., Fick G.H., et al. Azathioprine and 6-mercaptopurine in Crohn's disease. A meta-analysis. Ann Intern Med 1995, 123(2):132-142.
16. Surveillance, Epidemiology, and End Results Database Available at:, accessed on 4 August 2011. http://seer.cancer.gov/.
17. Lewis J.D., Schwartz J.S., Lichtenstein G.R. Azathioprine for maintenance of remission in Crohn's disease: benefits outweigh the risk of lymphoma. Gastroenterology 2000, 118:1018-1024.
18. Odes S., Vardi H., Friger M., et al. Clinical and economic outcomes in a population-based European cohort of 948 ulcerative colitis and Crohn's disease patient by Markov analysis. Aliment Pharmacol Ther 2010, 31:735-744.
19. The East of England Public Health Observatory Database Available at:, accessed on 4 August 2011. http://www.erpho.org.uk/.
20. Buchanan J., Wordsworth S., Ahmad T., et al. Managing the long term care of inflammatory bowel disease patients: the cost to European health care providers. J Crohns Colitis 2011, 5(4):301-316.
21. Sprakes M.B., Ford A.C., Suares N.C., et al. Costs of care for Crohn's disease following the introduction of infliximab: a single-centre UK experience. Aliment Pharmacol Ther 2010, 32:1357-1363.
22. Reis A., Ihle P., Paulus U., et al. Cost of illness of malignant lymphoma in Germany. Eur J Cancer Care 2006, 15(4):379-385.
23. Organization for Economic Co-operation and Development OECD Economic Outlook No. 87 Annex Tables-Table of Contents 2008.
24. Gregor J.C., McDonald J.W.D., Klar N., et al. An evaluation of utility measurements in Crohn's disease. Inflamm Bowel Dis 1997, 3:265-276.
25. Ochenrider M.G., Patterson D.J., Aboulafia D.M. Hepatosplenic T-cell lymphoma in a young man with Crohn's disease: case report and literature review. Clin Lymphoma Myeloma Leuk 2010, 10(2):144-148.
26. Lichtenstein G.R., Feagan B.G., Cohen R.D., et al. Serious infections and mortality in association with therapies for Crohn's disease: TREAT registry. Clin Gastroenterol Hepatol 2006, 4(5):621-630.
27. Dretzke J., Edlin R., Round J., et al. A systematic review and economic evaluation of the use of tumour necrosis factor-alpha (TNF-α) inhibitors, adalimumab and infliximab, for Crohn's disease. Health Technol Assess 2011, 5(6):1-244.
28. Siegel C.A., Finlayson S.R., Sands B.E., et al. Adverse events do not outweigh benefits of combination therapy for Crohn's disease in a decision analytic model. Clin Gastroenterol Hepatol 2012, 10(1):46-51.