Treatment cost of ulcerative colitis is apheresis with Adacolumn cost-effective?
BACKGROUND
Scarce data are available in Europe on the cost of treatment for ulcerative colitis (UC).


OBJECTIVE
To assess the cost of illness of moderate-to-severe UC in two scenarios: traditional treatment versus alternative treatment incorporating granulocyte, monocyte adsorption - apheresis (GMA-Apheresis; Adacolumn). To determine the relative cost-effectiveness of both options in steroid-dependent patients.


METHODS
One-year cost-of-illness and cost-effectiveness analysis from the third-payer perspective using a decision tree model was carried out. Probabilities of each event were derived from the literature and an expert panel. Direct medical costs were obtained from official sources (euro2004). Effectiveness was measured by the proportion of patients achieving clinical remission.


RESULTS
The average annual cost per patient treated with traditional treatment was estimated to be euro6740; with GMA-Apheresis, the cost was estimated to be euro6959. In steroid-dependent patients, the average annual cost was euro6059 and euro11,436, respectively. The proportion of patients achieving clinical remission with GMA-Apheresis was 22.5% higher. As second- and third-line therapy, a new course of corticosteroids and surgery was avoided in 18.5 and 4% of patients, respectively.


CONCLUSIONS
Incorporating GMA-Apheresis (Adacolumn) in the therapeutic management of moderate-to-severe UC patients is cost-effective and implies savings related to the reduction of adverse effects derived from corticosteroid use and to the decreased number of surgical interventions.
Panés
J
J
Gastroenterology Service, Hospital Clinic, Villarroel, 170, 08036 Barcelona, Spain.
Guilera
M
M
Ginard
D
D
Hinojosa
J
J
González-Carro
P
P
González-Lara
V
V
Varea
V
V
Domènech
E
E
Badia
X
X
D003093:Colitis, Ulcerative / Q000191:economics* / Q000628:therapy; D005500:Follow-Up Studies; D006098:Granulocytes; D017048:Health Care Costs; D006801:Humans; D007937:Leukapheresis / Q000191:economics* / Q000379:methods; D009000:Monocytes; D012074:Remission Induction; D012720:Severity of Illness Index; D013030:Spain; D016896:Treatment Outcome