Rudakova A V
Eksp Klin Gastroenterol. 2012(5):83-6.
Treatment of Crohn's disease (CD) is a very serious public health problem. Significant progress in this area has been provided by inhibitors of tumor necrosis factor (TNF), in particular, infliximab and adalimumab.
To estimate cost-effectiveness of induction of CD remission with TNF inhibitors.
The study was based on the Marcov modeling on the background of ACCENT I and CHARM research. Estimating the cost of hospitalization and surgery was carried out on the basis of tariffs compulsory health insurance at St. Petersburg in 2011.The research horizon was 1 year.
It Is shown that the "cost/effectiveness" (CE) for adalimumab is lower compared withj infliximab both in CD in moderate severity, and in severe CD. In severe CD, CE for adalimumab is 903.2 thousand rubles/QALY, that is, does not exceed the tripled gross domestic product per person, considered as an acceptable upper CE limit for the budget healthcare.
For induction of remission in patients with CD resistant to basic therapy without TNF inhibitors, it is advisable to use adalimumab, because with equal clinical efficacy of infliximab, it requires a smaller amount of additional costs.
克罗恩病（CD）的治疗是一个非常严重的公共卫生问题。肿瘤坏死因子（TNF）抑制剂，特别是英夫利昔单抗和阿达木单抗，在该领域取得了重大进展。
评估使用TNF抑制剂诱导CD缓解的成本效益。
该研究基于在ACCCENT I和CHARM研究背景下的马尔可夫模型。住院和手术费用的估算基于2011年圣彼得堡的强制医疗保险费率。研究期限为1年。
结果表明，在中度严重程度的CD以及重度CD中，阿达木单抗的“成本/效益”（CE）均低于英夫利昔单抗。在重度CD中，阿达木单抗的CE为90.32万卢布/质量调整生命年，即不超过人均国内生产总值的三倍，这被视为预算医疗保健可接受的CE上限。
对于对不含TNF抑制剂的基础治疗耐药的CD患者，诱导缓解时建议使用阿达木单抗，因为在英夫利昔单抗临床疗效相同的情况下，它所需的额外费用较少。
