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Dose Escalation and Healthcare Resource Use among Ulcerative Colitis Patients Treated with Adalimumab in English Hospitals: An Analysis of Real-World Data
OBJECTIVE: To describe the real-world use of adalimumab for maintenance treatment of ulcerative colitis (UC) and associated healthcare costs in English hospitals. DESIGN: Retrospective cohort study. SETTING: Analysis of NHS Hospital Episode Statistics linked with pharmacy dispensing data in English...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4768958/ https://www.ncbi.nlm.nih.gov/pubmed/26919745 http://dx.doi.org/10.1371/journal.pone.0149692 |
Sumario: | OBJECTIVE: To describe the real-world use of adalimumab for maintenance treatment of ulcerative colitis (UC) and associated healthcare costs in English hospitals. DESIGN: Retrospective cohort study. SETTING: Analysis of NHS Hospital Episode Statistics linked with pharmacy dispensing data in English hospitals. PATIENTS: Adult UC patients receiving ≥240mg during adalimumab treatment induction, subsequently maintained on adalimumab. OUTCOMES: Frequency and pattern of adalimumab use and dose escalation during maintenance treatment and associated healthcare costs (prescriptions and hospital visits). RESULTS: 191 UC patients completed adalimumab treatment induction. 83 (43.46%) dose escalated during maintenance treatment by ≥100% (equivalent to weekly dosing) (median time to dose escalation: 139 days). 56 patients (67.47%) subsequently de-escalated by ≥50% (median time to dose de-escalation: 21 days). Mean all-cause healthcare costs for all patients ≤12 months of index were £13,892. Dose escalators incurred greater mean healthcare costs than non-escalators ≤12 months of index (£14,596 vs. £13,351). Prescriptions accounted for 96.49% of UC-related healthcare costs (£11,090 of £11,494 in all patients). CONCLUSIONS: Within the cohort, 43.46% of UC patients escalated their adalimumab dose by ≥100% and incurred greater costs than non-escalators. The apparent underestimation of adalimumab dose escalation in previous studies may have resulted in underestimated costs in healthcare systems. |
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