AlRuthia Yazed, Alharbi Othman, Aljebreen Abdulrahman M, Azzam Nahla A, Almadi Majid A, Bahari Ohud H, Almalki Khalid A, Atham Abdulaziz T, Alanazi Ahmed S, Saeed Maria, HajkhderMullaissa Baraa, Alsenaidy Mohammad, Balkhi Bander
1Department of Clinical Pharmacy, College of Pharmacy, King Saud University, P.O. Box 2454, Riyadh, 11451 Saudi Arabia.
2Pharmacoeconomics Research Unit, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.
Cost Eff Resour Alloc. 2019 Dec 4;17:25. doi: 10.1186/s12962-019-0194-3. eCollection 2019.
There has been an increase in incidence and prevalence of inflammatory bowel disease (IBD) outside the western countries. Treatment costs are an essential component for healthcare planning and priority setting. The utilization patterns and annual administration and cost of IBD medications are largely unknown in countries with an increasing incidence of disease, Saudi Arabia being an example.
To evaluate the use of non-biologic and biologic agents and their associated annual administration costs in a sample of patients with Crohn's disease (CD) and ulcerative colitis (UC) in Saudi Arabia.
Single-center retrospective chart review was performed to determine the use of biologic and non-biologic medications among IBD patients in a tertiary care hospital in Riyadh, Saudi Arabia. Daily and the annual acquisition cost of different IBD therapeutic agents was calculated. The utilization rates and cost of each type of medication by CD and UC patients were compared.
Data of 258 CD patients and 249 UC patients were analyzed. Infliximab and adalimumab were the most commonly prescribed biologics among the study sample, however, their utilization rates were significantly higher among CD than UC patients (36.82% vs. 11.24%, and 20.54% vs. 9.64%, respectively, < 0. 01). Azathioprine utilization rate was also higher among CD patients compared to their UC counterparts (71.71% vs. 40.16%, respectively, < 0.01). However, the utilization rate of mesalazine in the UC patients was significantly higher than their CD counterparts (85.53% vs. 14.34% for CD, < 0.01). The annual cost of biologics (including administration and lab test cost) ranged from 5572 USD for ustekinumab to 18,424 USD for vedolizumab. On the other hand, the annual cost of non-biologics ranged from 16 USD for prednisone to 527 USD for methotrexate.
Biologics are extensively used in the management of IBD, particularly CD, and their utilization costs are significantly higher than non-biologics. Future studies should examine the cost effectiveness of IBD medications especially in countries with increasing incidence such as Saudi Arabia.
在西方国家以外，炎症性肠病（IBD）的发病率和患病率有所上升。治疗成本是医疗保健规划和优先事项设定的重要组成部分。在疾病发病率不断上升的国家，如沙特阿拉伯，IBD药物的使用模式以及年度用药量和成本在很大程度上尚不清楚。
评估沙特阿拉伯克罗恩病（CD）和溃疡性结肠炎（UC）患者样本中生物制剂和非生物制剂的使用情况及其相关年度用药成本。
进行单中心回顾性病历审查，以确定沙特阿拉伯利雅得一家三级护理医院中IBD患者使用生物制剂和非生物制剂的情况。计算不同IBD治疗药物的每日和年度采购成本。比较CD和UC患者每种药物的使用率和成本。
分析了258例CD患者和249例UC患者的数据。英夫利昔单抗和阿达木单抗是研究样本中最常用的生物制剂，然而，它们在CD患者中的使用率显著高于UC患者（分别为36.82%对11.24%，以及20.54%对9.64%，P<0.01）。与UC患者相比，CD患者中硫唑嘌呤的使用率也更高（分别为71.71%对40.16%，P<0.01）。然而，美沙拉嗪在UC患者中的使用率显著高于CD患者（CD患者为14.34%，UC患者为85.53%，P<0.01）。生物制剂的年度成本（包括给药和实验室检测成本）从优特克单抗的5572美元到维多珠单抗的18424美元不等。另一方面，非生物制剂的年度成本从泼尼松的16美元到甲氨蝶呤的527美元不等。
生物制剂广泛用于IBD的治疗，尤其是CD，其使用成本显著高于非生物制剂。未来的研究应考察IBD药物的成本效益，特别是在沙特阿拉伯等发病率不断上升的国家。
