title: Costs of providing infusion therapy for patients with inflammatory bowel disease in a hospital-based infusion center setting.
abstract: OBJECTIVE
  Inflammatory bowel disease (IBD) (e.g. ulcerative colitis [UC] and Crohn's disease [CD]) severely impacts patient quality-of-life. Moderate-to-severe disease is often treated with biologics requiring infusion therapy, adding incremental costs beyond drug costs. This study evaluates US hospital-based infusion services costs for treatment of UC or CD patients receiving infliximab or vedolizumab therapy.
  
  
  METHODS
  A model was developed, estimating annual costs of providing monitored infusions using an activity-based costing framework approach. Multiple sources (published literature, treatment product inserts) informed base-case model input estimates.
  
  
  RESULTS
  The total modeled per patient infusion therapy costs in Year 1 with infliximab and vedolizumab was $38,782 and $41,320, respectively, and Year 2+, $49,897 and $36,197, respectively. Drug acquisition cost was the largest total costs driver (90-93%), followed by costs associated with hospital-based infusion provision: labor (53-56%, non-drug costs), allocated overhead (23%, non-drug costs), non-labor (23%, non-drug costs), and laboratory (7-10%, non-drug costs).
  
  
  CONCLUSIONS
  Limitations included reliance on published estimates, base-case cost estimates infusion drug, and supplies, not accounting for volume pricing, assumption of a small hospital infusion center, and that, given the model adopts the hospital perspective, costs to the patient were not included in infusion administration cost base-case estimates.
  
  
  CONCLUSIONS
  This model is an early step towards a framework to fully analyze infusion therapies' associated costs. Given the lack of published data, it would be beneficial for hospital administrators to assess total costs and trade-offs with alternative means of providing biologic therapies. This analysis highlights the value to hospital administrators of assessing cost associated with infusion patient mix to make more informed resource allocation decisions. As the landscape for reimbursement changes, tools for evaluating the costs of infusion therapy may help hospital administrators make informed choices and weigh trade-offs associated with providing infusion services for IBD patients.
authors.affiliation: a University of Washington - Harborview Medical Center , Seattle , WA , USA.
authors.forename: Anita
authors.initials: A
authors.lastname: Afzali
authors.affiliation: b ICON plc, Health Economics , San Francisco , CA , USA.
authors.forename: Kristine
authors.initials: K
authors.lastname: Ogden
authors.affiliation: b ICON plc, Health Economics , San Francisco , CA , USA.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Friedman
authors.affiliation: c AbbVie , North Chicago , IL , USA.
authors.forename: Jingdong
authors.initials: J
authors.lastname: Chao
authors.affiliation: c AbbVie , North Chicago , IL , USA.
authors.forename: Anthony
authors.initials: A
authors.lastname: Wang
mesh_terms: D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000191:economics; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D003093:Colitis, Ulcerative / Q000188:drug therapy*; D003424:Crohn Disease / Q000188:drug therapy*; D005252:Fees, Pharmaceutical; D005765:Gastrointestinal Agents / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D017048:Health Care Costs; D006801:Humans; D000069285:Infliximab / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D007262:Infusions, Intravenous / Q000191:economics*; D014481:United States
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D005765:Gastrointestinal Agents; C543529:vedolizumab; D000069285:Infliximab
keywords: Crohn’s disease; Inflammatory bowel disease; health economics; large intestine; outcomes research; small intestine; ulcerative colitis