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Hépato-Gastro & Oncologie Digestive

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The economic aspects of IBD Volume 22, supplement 2, Octobre 2015

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Author
PSL, Université Paris-Dauphine,
LEDa-LEGOS,
Place du Maréchal de Lattre de Tassigny,
75775 Paris cedex 16,
France
* Tirés à part

Two types of approach can be used to assess the economic aspects of IBD. Cost of illness studies are devoted to measuring the economic burden of a disease on the healthcare system and the patients. In the case of IBD, numerous studies are available but none refers to the French setting. The transferability of this literature is limited because some studies are obsolete given the recent availability of anti-TNF agents and others are devoted to countries such the USA with limited comparability. In Europe, the annual cost per patient from the payer perspective for Crohn's disease is estimated to be between €3,500 to €6,500 and around €2,400 for UC (of which 70 % to 80 % for drugs in both cases), with a downward trend over preceding decades associated with a reduction in hospitalizations.

Cost-effectiveness studies assess the efficiency of alternative treatments by comparing their costs and their respective therapeutic benefits to identify the most effective at lower cost. Efficiency is preferentially measured in terms of Quality-Adjusted Life-Years (QALYs), and treatments are generally deemed as efficient when the cost per QALY is below €30,000. In Crohn's disease, anti-TNF agents appear not efficient in maintenance treatment. They are nevertheless efficient as induction treatment, at least for severe patients (CDAI > 300). Many uncertainties still remain which will be reduced only by additional data from real-life, long-term studies or claim databases.