IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0185500.html
   My bibliography  Save this article

A systematic review of cost-effectiveness studies comparing conventional, biological and surgical interventions for inflammatory bowel disease

Author

Listed:
  • Nadia Pillai
  • Mark Dusheiko
  • Bernard Burnand
  • Valérie Pittet

Abstract

Background: Inflammatory bowel disease (IBD) is a chronic disease placing a large health and economic burden on health systems worldwide. The treatment landscape is complex with multiple strategies to induce and maintain remission while avoiding long-term complications. The extent to which rising treatment costs, due to expensive biologic agents, are offset by improved outcomes and fewer hospitalisations and surgeries needs to be evaluated. This systematic review aimed to assess the cost-effectiveness of treatment strategies for IBD. Materials and methods: A systematic literature search was performed in March 2017 to identify economic evaluations of pharmacological and surgical interventions, for adults diagnosed with Crohn’s disease (CD) or ulcerative colitis (UC). Costs and incremental cost-effectiveness ratios (ICERs) were adjusted to reflect 2015 purchasing power parity (PPP). Risk of bias assessments and a narrative synthesis of individual study findings are presented. Results: Forty-nine articles were included; 24 on CD and 25 on UC. Infliximab and adalimumab induction and maintenance treatments were cost-effective compared to standard care in patients with moderate or severe CD; however, in patients with conventional-drug refractory CD, fistulising CD and for maintenance of surgically-induced remission ICERs were above acceptable cost-effectiveness thresholds. In mild UC, induction of remission using high dose mesalazine was dominant compared to standard dose. In UC refractory to conventional treatments, infliximab and adalimumab induction and maintenance treatment were not cost-effective compared to standard care; however, ICERs for treatment with vedolizumab and surgery were favourable. Conclusions: We found that, in general, while biologic agents helped improve outcomes, they incurred high costs and therefore were not cost-effective, particularly for use as maintenance therapy. The cost-effectiveness of biologic agents may improve as market prices fall and with the introduction of biosimilars. Future research should identify optimal treatment strategies reflecting routine clinical practice, incorporate indirect costs and evaluate lifetime costs and benefits.

Suggested Citation

  • Nadia Pillai & Mark Dusheiko & Bernard Burnand & Valérie Pittet, 2017. "A systematic review of cost-effectiveness studies comparing conventional, biological and surgical interventions for inflammatory bowel disease," PLOS ONE, Public Library of Science, vol. 12(10), pages 1-22, October.
  • Handle: RePEc:plo:pone00:0185500
    DOI: 10.1371/journal.pone.0185500
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0185500
    Download Restriction: no

    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0185500&type=printable
    Download Restriction: no

    File URL: https://libkey.io/10.1371/journal.pone.0185500?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Andrew Yu & Scott Johnson & Si-Tien Wang & Pavel Atanasov & Jackson Tang & Eric Wu & Jingdong Chao & Parvez Mulani, 2009. "Cost Utility of Adalimumab versus Infliximab Maintenance Therapies in the United States for Moderately to Severely Active Crohn’s Disease," PharmacoEconomics, Springer, vol. 27(7), pages 609-621, July.
    2. Saara Huoponen & Marja Blom, 2015. "A Systematic Review of the Cost-Effectiveness of Biologics for the Treatment of Inflammatory Bowel Diseases," PLOS ONE, Public Library of Science, vol. 10(12), pages 1-23, December.
    3. Ewa Stawowczyk & Paweł Kawalec & Andrzej Pilc, 2016. "Cost-Effectiveness Analysis of 1-Year Treatment with Golimumab/Standard Care and Standard Care Alone for Ulcerative Colitis in Poland," PLOS ONE, Public Library of Science, vol. 11(8), pages 1-11, August.
    4. Rob Anderson, 2010. "Systematic reviews of economic evaluations: utility or futility?," Health Economics, John Wiley & Sons, Ltd., vol. 19(3), pages 350-364, March.
    5. Karl Claxton & Mark Sculpher & Stephen Palmer & Anthony J Culyer, 2015. "Causes For Concern: Is Nice Failing To Uphold Its Responsibilities To All Nhs Patients?," Health Economics, John Wiley & Sons, Ltd., vol. 24(1), pages 1-7, January.
    6. Rachid Rafia & Alison Scope & Sue Harnan & John W. Stevens & Matt Stevenson & Alan Lobo, 2016. "Vedolizumab for Treating Moderately to Severely Active Crohn’s Disease After Prior Therapy: An Evidence Review Group Perspective of a NICE Single Technology Appraisal," PharmacoEconomics, Springer, vol. 34(12), pages 1241-1253, December.
    7. Monia Marchetti & Nicola Liberato & Antonio Sabatino & Gino Corazza, 2013. "Cost-effectiveness analysis of top-down versus step-up strategies in patients with newly diagnosed active luminal Crohn’s disease," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(6), pages 853-861, December.
    8. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
    9. Paul Tappenden & Shijie Ren & Rachel Archer & Rebecca Harvey & Marrissa Martyn-St James & Hasan Basarir & John Stevens & Alan Lobo & Sami Hoque, 2016. "A Model-Based Economic Evaluation of Biologic and Non-Biologic Options for the Treatment of Adults with Moderately-to-Severely Active Ulcerative Colitis after the Failure of Conventional Therapy," PharmacoEconomics, Springer, vol. 34(10), pages 1023-1038, October.
    10. Yogesh Punekar & Neil Hawkins, 2010. "Cost-effectiveness of infliximab for the treatment of acute exacerbations of ulcerative colitis," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(1), pages 67-76, February.
    11. Drummond, Michael F. & Sculpher, Mark J. & Claxton, Karl & Stoddart, Greg L. & Torrance, George W., 2015. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 4, number 9780199665884.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. James Lomas & Jessica Ochalek & Rita Faria, 2022. "Avoiding Opportunity Cost Neglect in Cost-Effectiveness Analysis for Health Technology Assessment," Applied Health Economics and Health Policy, Springer, vol. 20(1), pages 13-18, January.
    2. Claxton, Karl & Asaria, Miqdad & Chansa, Collins & Jamison, Julian & Lomas, James & Ochalek, Jessica & Paulden, Mike, 2019. "Accounting for timing when assessing health-related policies," LSE Research Online Documents on Economics 100038, London School of Economics and Political Science, LSE Library.
    3. Darcy M. Anderson & Ryan Cronk & Donald Fejfar & Emily Pak & Michelle Cawley & Jamie Bartram, 2021. "Safe Healthcare Facilities: A Systematic Review on the Costs of Establishing and Maintaining Environmental Health in Facilities in Low- and Middle-Income Countries," IJERPH, MDPI, vol. 18(2), pages 1-22, January.
    4. Antonio Ahumada-Canale & Camila Quirland & Francisco J. Martinez-Mardones & José Cristian Plaza-Plaza & Shalom Benrimoj & Victoria Garcia-Cardenas, 2019. "Economic evaluations of pharmacist-led medication review in outpatients with hypertension, type 2 diabetes mellitus, and dyslipidaemia: a systematic review," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(7), pages 1103-1116, September.
    5. Susanne Mayer & Noemi Kiss & Agata Łaszewska & Judit Simon, 2017. "Costing evidence for health care decision-making in Austria: A systematic review," PLOS ONE, Public Library of Science, vol. 12(8), pages 1-18, August.
    6. Nystrand, Camilla & Gebreslassie, Mihretab & Ssegonja, Richard & Feldman, Inna & Sampaio, Filipa, 2021. "A systematic review of economic evaluations of public health interventions targeting alcohol, tobacco, illicit drug use and problematic gambling: Using a case study to assess transferability," Health Policy, Elsevier, vol. 125(1), pages 54-74.
    7. Alec Morton & Amanda I. Adler & David Bell & Andrew Briggs & Werner Brouwer & Karl Claxton & Neil Craig & Alastair Fischer & Peter McGregor & Pieter van Baal, 2016. "Unrelated Future Costs and Unrelated Future Benefits: Reflections on NICE Guide to the Methods of Technology Appraisal," Health Economics, John Wiley & Sons, Ltd., vol. 25(8), pages 933-938, August.
    8. Jessica Ochalek & Karl Claxton & Paul Revill & Mark Sculpher & Alexandra Rollinger, 2016. "Supporting the development of an essential health package: principles and initial assessment for Malawi," Working Papers 136cherp, Centre for Health Economics, University of York.
    9. Henriette Busk & Ulrik Sidenius & Line Planck Kongstad & Sus Sola Corazon & Christina Bjørk Petersen & Dorthe Varning Poulsen & Patrik Karlsson Nyed & Ulrika Karlsson Stigsdotter, 2022. "Economic Evaluation of Nature-Based Therapy Interventions—A Scoping Review," Challenges, MDPI, vol. 13(1), pages 1-19, May.
    10. Edward Burn & Alexander D. Liddle & Thomas W. Hamilton & Sunil Pai & Hemant G. Pandit & David W. Murray & Rafael Pinedo-Villanueva, 2017. "Choosing Between Unicompartmental and Total Knee Replacement: What Can Economic Evaluations Tell Us? A Systematic Review," PharmacoEconomics - Open, Springer, vol. 1(4), pages 241-253, December.
    11. Ahmed Ramadan Shokry Shahat & Giulia Greco, 2021. "The Economic Costs of Childhood Disability: A Literature Review," IJERPH, MDPI, vol. 18(7), pages 1-25, March.
    12. Miriam Kasztura & Aude Richard & Nefti-Eboni Bempong & Dejan Loncar & Antoine Flahault, 2019. "Cost-effectiveness of precision medicine: a scoping review," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 64(9), pages 1261-1271, December.
    13. Zartashia Ghani & Johan Jarl & Johan Sanmartin Berglund & Martin Andersson & Peter Anderberg, 2020. "The Cost-Effectiveness of Mobile Health (mHealth) Interventions for Older Adults: Systematic Review," IJERPH, MDPI, vol. 17(15), pages 1-13, July.
    14. Mina Bahrampour & Joshua Byrnes & Richard Norman & Paul A. Scuffham & Martin Downes, 2020. "Discrete choice experiments to generate utility values for multi-attribute utility instruments: a systematic review of methods," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(7), pages 983-992, September.
    15. Peter J. Neumann & David D. Kim & Thomas A. Trikalinos & Mark J. Sculpher & Joshua A. Salomon & Lisa A. Prosser & Douglas K. Owens & David O. Meltzer & Karen M. Kuntz & Murray Krahn & David Feeny & An, 2018. "Future Directions for Cost-effectiveness Analyses in Health and Medicine," Medical Decision Making, , vol. 38(7), pages 767-777, October.
    16. Peter Wigfield & Urbano Sbarigia & Mahmoud Hashim & Talitha Vincken & Bart Heeg, 2020. "Are Published Health Economic Models for Chronic Hepatitis B Appropriately Capturing the Benefits of HBsAg Loss? A Systematic Literature Review," PharmacoEconomics - Open, Springer, vol. 4(3), pages 403-418, September.
    17. Valentin Brodszky & Zsuzsanna Beretzky & Petra Baji & Fanni Rencz & Márta Péntek & Alexandru Rotar & Konstantin Tachkov & Susanne Mayer & Judit Simon & Maciej Niewada & Rok Hren & László Gulácsi, 2019. "Cost-of-illness studies in nine Central and Eastern European countries," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(1), pages 155-172, June.
    18. Banke-Thomas, Aduragbemi & Aberjirinde, Ibukun-Oluwa & Ayomoh, Francis Ifeanyi & Banke-Thomas, Oluwasola & Eboreime, Ejemai Amaize & Ameh, Charles, 2020. "The cost of maternal health services in low-income and middle-income countries from a provider's perspective: a systematic review," LSE Research Online Documents on Economics 104344, London School of Economics and Political Science, LSE Library.
    19. Jason R. Guertin & Blanchard Conombo & Raphaël Langevin & Frédéric Bergeron & Anne Holbrook & Brittany Humphries & Alexis Matteau & Brian J. Potter & Christel Renoux & Jean-Éric Tarride & Madelein, 2020. "A Systematic Review of Methods Used for Confounding Adjustment in Observational Economic Evaluations in Cardiology Conducted between 2013 and 2017," Medical Decision Making, , vol. 40(5), pages 582-595, July.
    20. Salah Ghabri & Laurent Lam & François Bocquet & Hans-Martin Spath, 2020. "Systematic Literature Review of Economic Evaluations of Biological Treatment Sequences for Patients with Moderate to Severe Rheumatoid Arthritis Previously Treated with Disease-Modifying Anti-rheumati," PharmacoEconomics, Springer, vol. 38(5), pages 459-471, May.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0185500. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.