Digestive Diseases Clinical Academic Unit, Barts Health NHS Trust and Barts and the London School of Medicine, Queen Mary University of London, London, UK.
Aliment Pharmacol Ther. 2013 Jul;38(1):52-61. doi: 10.1111/apt.12339. Epub 2013 May 23.
Crohn's disease (CD) places a substantial burden on healthcare systems, with the majority of costs arising from hospitalisation and surgery.
To evaluate the 'real-world' clinical effectiveness, impact on healthcare utilisation and cost of infliximab for the treatment of CD in UK practice.
A non-interventional, retrospective analysis of medical records from patients with CD treated with infliximab at 18 hospital centres across the UK. The primary objective was to compare cumulative clinical outcomes and healthcare resource utilisation for the 0- to 24-month post-infliximab period with the 12 months preceding infliximab treatment. Predefined outcomes included the number of elective surgical procedures, hospitalisations and healthcare provider consultations. Costs associated with healthcare utilisation were collected from the perspective of the UK National Health Service (NHS).
The study involved 380 patients. Infliximab significantly reduced the mean number of elective (from 0.18 to 0.11; P = 0.0035) and non-elective (from 0.46 to 0.29; P < 0.0001) hospitalisations, and the number of consultations with gastroenterologists, gastrointestinal surgeons and radiologists (from 4.0 to 3.5, from 0.7 to 0.5 and from 0.5 to 0.2, respectively; all P < 0.001); all decreases were associated with significant cost reductions. The mean number of elective surgical procedures (including correction of severe anal fistulae and abscess drainage) was significantly reduced.
The observed reductions in numbers of hospitalisations, surgical procedures and consultations with healthcare professionals are key indicators of the clinical effectiveness of infliximab for the treatment of CD. These benefits result in overall decreases in healthcare resource utilisation, which translate into cost savings for the NHS.
克罗恩病(CD)给医疗系统带来了巨大的负担,大部分费用来自住院和手术。
评估英夫利昔单抗治疗 CD 的“真实世界”临床疗效、对医疗资源利用的影响和成本。
对英国 18 家医院中心的 CD 患者使用英夫利昔单抗治疗的病历进行非干预性、回顾性分析。主要目的是比较英夫利昔单抗治疗后 0-24 个月与英夫利昔单抗治疗前 12 个月的累积临床结果和医疗资源利用情况。预先定义的结果包括择期手术次数、住院次数和医疗服务提供者的咨询次数。从英国国家医疗服务体系(NHS)的角度收集与医疗保健利用相关的成本。
该研究共纳入 380 例患者。英夫利昔单抗显著减少了择期(从 0.18 降至 0.11;P=0.0035)和非择期(从 0.46 降至 0.29;P<0.0001)住院的次数,以及与胃肠病学家、胃肠外科医生和放射科医生的咨询次数(从 4.0 降至 3.5,从 0.7 降至 0.5,从 0.5 降至 0.2;均 P<0.001);所有下降均与显著的成本降低相关。择期手术次数(包括严重肛门瘘和脓肿引流的矫正)显著减少。
住院次数、手术次数和与医疗保健专业人员咨询次数的减少是英夫利昔单抗治疗 CD 的临床疗效的关键指标。这些益处导致医疗资源利用总体减少,从而为 NHS 节省成本。