title: Impact of persistence with infliximab on hospitalizations in ulcerative colitis.
abstract: OBJECTIVE
  To assess infliximab infusion patterns in ulcerative colitis (UC) and assess the impact of persistence with infliximab maintenance therapy on UC-related hospitalizations, lengths of stay, and inpatient costs.
  
  
  METHODS
  Retrospective analysis of medical claims for UC patients newly initiating infliximab treatment.
  
  
  METHODS
  Patients were aged >18 years and had 2 UC diagnosis codes, an infliximab index date between September 1, 2005, and January 31, 2008, and continuous enrollment for >12 months before and >14 months after the index date. Infliximab induction (first 56 days postindex) and maintenance (>56 days and <12 months postinduction) patterns were evaluated. Of patients with maintenance treatment, persistence was defined as a medication possession ratio (MPR) of >80%, and this group was compared with those without persistence (<80% MPR).
  
  
  RESULTS
  Overall, 420 patients were included in the analysis; 84.3% (n = 354) continued to maintenance therapy. Maintenance infusion patterns were consistent with recommended prescribing information. A smaller proportion of patients with maintenance therapy persistence required hospitalization compared with patients without persistence (3.0% vs 20.4%; P <.001). Hospitalized patients with maintenance therapy persistence had significantly lower mean inpatient costs ($14,243 vs $32,745; P = .046), with a trend toward shorter mean lengths of stay (6.67 vs 9.71 days; P = .147) than patients without persistence.
  
  
  CONCLUSIONS
  Infliximab maintenance therapy persistence in UC was associated with significantly fewer hospitalizations. Once hospitalized, patients with therapeutic persistence had significantly decreased inpatient costs.
authors.affiliation: Centocor Ortho Biotech Services, LLC, 800 Ridgeview Dr., Horsham, PA 19044, USA. ccarte10@its.jnj.com
authors.forename: Chureen T
authors.initials: CT
authors.lastname: Carter
authors.forename: Henry
authors.initials: H
authors.lastname: Leher
authors.forename: Paula
authors.initials: P
authors.lastname: Smith
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Smith
authors.forename: Heidi C
authors.initials: HC
authors.lastname: Waters
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D003093:Colitis, Ulcerative / Q000188:drug therapy* / Q000191:economics; D003362:Cost-Benefit Analysis; D005260:Female; D005765:Gastrointestinal Agents / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D000069285:Infliximab; D007262:Infusions, Intravenous; D007345:Insurance Claim Review; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D014481:United States
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D005765:Gastrointestinal Agents; D000069285:Infliximab