title: A UK retrospective observational study of clinical outcomes and healthcare resource utilisation of infliximab treatment in Crohn's disease.
abstract: BACKGROUND
  Crohn's disease (CD) places a substantial burden on healthcare systems, with the majority of costs arising from hospitalisation and surgery.
  
  
  OBJECTIVE
  To evaluate the 'real-world' clinical effectiveness, impact on healthcare utilisation and cost of infliximab for the treatment of CD in UK practice.
  
  
  METHODS
  A non-interventional, retrospective analysis of medical records from patients with CD treated with infliximab at 18 hospital centres across the UK. The primary objective was to compare cumulative clinical outcomes and healthcare resource utilisation for the 0- to 24-month post-infliximab period with the 12 months preceding infliximab treatment. Predefined outcomes included the number of elective surgical procedures, hospitalisations and healthcare provider consultations. Costs associated with healthcare utilisation were collected from the perspective of the UK National Health Service (NHS).
  
  
  RESULTS
  The study involved 380 patients. Infliximab significantly reduced the mean number of elective (from 0.18 to 0.11; P = 0.0035) and non-elective (from 0.46 to 0.29; P < 0.0001) hospitalisations, and the number of consultations with gastroenterologists, gastrointestinal surgeons and radiologists (from 4.0 to 3.5, from 0.7 to 0.5 and from 0.5 to 0.2, respectively; all P < 0.001); all decreases were associated with significant cost reductions. The mean number of elective surgical procedures (including correction of severe anal fistulae and abscess drainage) was significantly reduced.
  
  
  CONCLUSIONS
  The observed reductions in numbers of hospitalisations, surgical procedures and consultations with healthcare professionals are key indicators of the clinical effectiveness of infliximab for the treatment of CD. These benefits result in overall decreases in healthcare resource utilisation, which translate into cost savings for the NHS.
authors.affiliation: Digestive Diseases Clinical Academic Unit, Barts Health NHS Trust and Barts and the London School of Medicine, Queen Mary University of London, London, UK. james.lindsay@bartshealth.nhs.uk
authors.forename: J O
authors.initials: JO
authors.lastname: Lindsay
authors.forename: R
authors.initials: R
authors.lastname: Chipperfield
authors.forename: A
authors.initials: A
authors.lastname: Giles
authors.forename: C
authors.initials: C
authors.lastname: Wheeler
authors.forename: T
authors.initials: T
authors.lastname: Orchard
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000191:economics* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D003424:Crohn Disease / Q000188:drug therapy / Q000191:economics*; D003695:Delivery of Health Care / Q000191:economics*; D005260:Female; D005765:Gastrointestinal Agents / Q000191:economics* / Q000627:therapeutic use; D017048:Health Care Costs; D006295:Health Resources / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007223:Infant; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D006113:United Kingdom; D055815:Young Adult
chemical_list: D000911:Antibodies, Monoclonal; D005765:Gastrointestinal Agents; D000069285:Infliximab