[Cost-effectiveness of tumor necrosis factor in Crohn's disease].

UNLABELLED

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.

OBJECTIVE

To estimate cost-effectiveness of induction of CD remission with TNF inhibitors.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.