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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 |
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author | Black, Christopher M. Yu, Eric McCann, Eilish Kachroo, Sumesh |
author_facet | Black, Christopher M. Yu, Eric McCann, Eilish Kachroo, Sumesh |
author_sort | Black, Christopher M. |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-4768958 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-47689582016-03-09 Dose Escalation and Healthcare Resource Use among Ulcerative Colitis Patients Treated with Adalimumab in English Hospitals: An Analysis of Real-World Data Black, Christopher M. Yu, Eric McCann, Eilish Kachroo, Sumesh PLoS One Research Article 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. Public Library of Science 2016-02-26 /pmc/articles/PMC4768958/ /pubmed/26919745 http://dx.doi.org/10.1371/journal.pone.0149692 Text en © 2016 Black et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Black, Christopher M. Yu, Eric McCann, Eilish Kachroo, Sumesh Dose Escalation and Healthcare Resource Use among Ulcerative Colitis Patients Treated with Adalimumab in English Hospitals: An Analysis of Real-World Data |
title | Dose Escalation and Healthcare Resource Use among Ulcerative Colitis Patients Treated with Adalimumab in English Hospitals: An Analysis of Real-World Data |
title_full | Dose Escalation and Healthcare Resource Use among Ulcerative Colitis Patients Treated with Adalimumab in English Hospitals: An Analysis of Real-World Data |
title_fullStr | Dose Escalation and Healthcare Resource Use among Ulcerative Colitis Patients Treated with Adalimumab in English Hospitals: An Analysis of Real-World Data |
title_full_unstemmed | Dose Escalation and Healthcare Resource Use among Ulcerative Colitis Patients Treated with Adalimumab in English Hospitals: An Analysis of Real-World Data |
title_short | Dose Escalation and Healthcare Resource Use among Ulcerative Colitis Patients Treated with Adalimumab in English Hospitals: An Analysis of Real-World Data |
title_sort | dose escalation and healthcare resource use among ulcerative colitis patients treated with adalimumab in english hospitals: an analysis of real-world data |
topic | Research Article |
url | 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 |
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