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J Med Econ. 2017 Apr;20(4):409-422. doi: 10.1080/13696998.2017.1285779. Epub 2017 Feb 10.

Costs of providing infusion therapy for patients with inflammatory bowel disease in a hospital-based infusion center setting.

Author information

1
a University of Washington - Harborview Medical Center , Seattle , WA , USA.
2
b ICON plc, Health Economics , San Francisco , CA , USA.
3
c AbbVie , North Chicago , IL , USA.

Abstract

AIMS:

Inflammatory bowel disease (IBD) (e.g. ulcerative colitis [UC] and Crohn's disease [CD]) severely impacts patient quality-of-life. Moderate-to-severe disease is often treated with biologics requiring infusion therapy, adding incremental costs beyond drug costs. This study evaluates US hospital-based infusion services costs for treatment of UC or CD patients receiving infliximab or vedolizumab therapy.

MATERIALS AND METHODS:

A model was developed, estimating annual costs of providing monitored infusions using an activity-based costing framework approach. Multiple sources (published literature, treatment product inserts) informed base-case model input estimates.

RESULTS:

The total modeled per patient infusion therapy costs in Year 1 with infliximab and vedolizumab was $38,782 and $41,320, respectively, and Year 2+, $49,897 and $36,197, respectively. Drug acquisition cost was the largest total costs driver (90-93%), followed by costs associated with hospital-based infusion provision: labor (53-56%, non-drug costs), allocated overhead (23%, non-drug costs), non-labor (23%, non-drug costs), and laboratory (7-10%, non-drug costs).

LIMITATIONS:

Limitations included reliance on published estimates, base-case cost estimates infusion drug, and supplies, not accounting for volume pricing, assumption of a small hospital infusion center, and that, given the model adopts the hospital perspective, costs to the patient were not included in infusion administration cost base-case estimates.

CONCLUSIONS:

This model is an early step towards a framework to fully analyze infusion therapies' associated costs. Given the lack of published data, it would be beneficial for hospital administrators to assess total costs and trade-offs with alternative means of providing biologic therapies. This analysis highlights the value to hospital administrators of assessing cost associated with infusion patient mix to make more informed resource allocation decisions. As the landscape for reimbursement changes, tools for evaluating the costs of infusion therapy may help hospital administrators make informed choices and weigh trade-offs associated with providing infusion services for IBD patients.

KEYWORDS:

Crohn’s disease; Inflammatory bowel disease; health economics; large intestine; outcomes research; small intestine; ulcerative colitis

PMID:
28112566
DOI:
10.1080/13696998.2017.1285779
[Indexed for MEDLINE]

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