scholarly journals P500 The effects of EBV naïve status on treatment decisions in patients with inflammatory bowel disease: Does the risk of GI lymphoma justify the cost?

2018 ◽  
Vol 12 (supplement_1) ◽  
pp. S358-S358
Author(s):  
T Ahmed ◽  
F Brown ◽  
R Ahmed ◽  
S Whitehead ◽  
H Steed ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Treatment Decisions ◽  
Inflammatory Bowel ◽  
The Cost

Home Enteral Tube Feeding with a Liquid Diet in the Long Term Management of Inflammatory Bowel Disease and Intestinal Failure

1980 ◽  
Vol 25 (4) ◽  
pp. 312-314 ◽  
Author(s):  
A. N. H. Main ◽  
R. J. Morgan ◽  
M. J. Hall ◽  
R. I. Russell ◽  
A. Shenkin ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Elemental Diet ◽  
Intestinal Failure ◽  
Tube Feeding ◽  
Liquid Diet ◽  
Intravenous Nutrition ◽  
Inflammatory Bowel ◽  
The Cost

A 35-year-old man, who had spent 10[Formula: see text] out of 18 months in hospital, has required repeated courses of intravenous nutrition (IVN) because of nutritional failure due to severe inflammatory bowel disease. He has been maintained on a nocturnal pump-fed liquid diet supplementing his day-time oral diet jar five months, four of which have been at home. The cost of such therapy is less than with an elemental diet and there are other advantages. This regime has been shown to be nutritionally adequate. The need to assess other cheaper liquid diets in patients with intestinal failure is recognised.

scholarly journals The Treatment of Inflammatory Bowel Disease in Patients With a History of Malignancy

2018 ◽  
Vol 25 (6) ◽  
pp. 998-1005 ◽  
Author(s):  
Steven C Lin ◽  
Alex Goldowsky ◽  
Konstantinos Papamichael ◽  
Adam S Cheifetz
Keyword(s):  
Inflammatory Bowel Disease ◽  
Current Literature ◽  
Bowel Disease ◽  
Treatment Strategy ◽  
Treatment Decisions ◽  
Inherent Risk ◽  
History Of ◽  
Inflammatory Bowel ◽  
Immunomodulatory Therapies

Abstract As patients with inflammatory bowel disease (IBD) are living longer and our medical armamentarium expands, gastroenterologists are more frequently faced with treatment decisions about patients with IBD who also have a history of malignancy. This review aims to summarize the current literature on IBD, the inherent risk of developing gastrointestinal and extra-intestinal malignancies, and the risk of malignancies associated with available biologic and immunomodulatory therapies and to discuss the overall treatment strategy for a patient with a history of malignancy.

scholarly journals Infliximab Therapeutic Drug Monitoring in Inflammatory Bowel Disease Virtual Biologics Clinic Leads to Durable Clinical Results

2021 ◽  
pp. 1-8
Author(s):  
Rebecca Sagar ◽  
Marco V. Lenti ◽  
Tanya Clark ◽  
Helen J. Rafferty ◽  
David J. Gracie ◽  
...  
Keyword(s):  
Health Care ◽  
Inflammatory Bowel Disease ◽  
Therapeutic Drug Monitoring ◽  
Bowel Disease ◽  
Drug Monitoring ◽  
Treatment Decisions ◽  
Therapeutic Drug ◽  
Initial Decision ◽  
Inflammatory Bowel ◽  
Care Costs

<b><i>Background:</i></b> Therapeutic drug monitoring (TDM) of infliximab (IFX) trough levels and anti-drug antibodies in conjunction with symptoms, disease history, and investigations can aid decision-making. This study evaluated 1-year outcomes of patients with decisions that were altered on the basis of TDM results, in order to investigate whether outcomes from TDM-based decisions to adjust or stop IFX treatment are durable. <b><i>Methods:</i></b> We retrospectively collected clinical outcomes 12 months post treatment decisions based on proactive TDM. Patients whose initial treatment decisions were altered on the basis of TDM results were compared with those where the decision remained unchanged. Events of interest were inpatient admissions with active inflammatory bowel disease (IBD), further changes to biologic therapy, and IBD-related health-care costs. <b><i>Results:</i></b> Of 189 patients, 54 (28%) had initial treatment decisions altered in the light of TDM results. The 135 patients whose initial decision was not altered in light of TDM results served as the comparator. There were no differences in hospitalization rates or subsequent biologic switches between the altered decision groups and the comparator group. IBD-related health-care costs were higher in those whose initial decision was altered (median GBP 7,912 vs. GBP 6,521; <i>p</i> &#x3c; 0.0001) due to higher drug costs (median GBP 7,062 vs. GBP 6,012; <i>p</i> &#x3c; 0.0001). <b><i>Conclusion:</i></b> Our study demonstrates good outcomes from changes to IFX treatment based on TDM. Patients with a decision to stop, switch, or continue with an adjusted IFX dose experienced comparable clinical outcomes but had higher drug-related expenditure than those whose treatment decision was not altered in light of TDM.

scholarly journals The Cost of Inflammatory Bowel Disease Inpatient Care

2011 ◽  
Vol 140 (5) ◽  
pp. S-735
Author(s):  
Marc Schwartz ◽  
Marwa El Mourabet ◽  
Melissa I. Saul ◽  
Miguel Regueiro ◽  
Leonard Baidoo ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Inpatient Care ◽  
Inflammatory Bowel ◽  
The Cost

scholarly journals Telemonitoring of Crohn’s Disease and Ulcerative Colitis (TECCU): Cost-Effectiveness Analysis (Preprint)

2019 ◽  
Author(s):  
Javier Del Hoyo ◽  
Pilar Nos ◽  
Guillermo Bastida ◽  
Raquel Faubel ◽  
Diana Muñoz ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Cost Effectiveness ◽  
Bowel Disease ◽  
Intervention Group ◽  
Additional Patient ◽  
Inflammatory Bowel ◽  
The Cost ◽  
Web Platform ◽  
Quality Adjusted Life

BACKGROUND Although electronic health interventions are considered safe and efficient, evidence regarding the cost-effectiveness of telemonitoring in inflammatory bowel disease is lacking. OBJECTIVE We aimed to evaluate the cost-effectiveness and cost-utility of the Telemonitorización de la Enfermedad de Crohn y Colitis Ulcerosa (Telemonitoring of Crohn’s Disease and Ulcerative Colitis [TECCU]) Web platform (G_TECCU intervention group) for telemonitoring complex inflammatory bowel disease, compared with standard care (G_control) and nurse-assisted telephone care (G_NT intervention group). METHODS We analyzed cost-effectiveness from a societal perspective by comparing the 3 follow-up methods used in a previous 24-week randomized controlled trial, conducted at a tertiary university hospital in Spain. Patients with inflammatory bowel disease who initiated immunosuppressants or biologic agents, or both, to control inflammatory activity were recruited consecutively. Data on the effects on disease activity (using clinical indexes) and quality-adjusted life-years (using the EuroQol 5 dimensions questionnaire) were collected. We calculated the costs of health care, equipment, and patients’ productivity and social activity impairment. We compared the mean costs per patient, utilities, and bootstrapped differences. RESULTS We included 63 patients (21 patients per group). TECCU saved €1005 (US $1100) per additional patient in remission compared with G_control (95% CI €–13,518 to 3137; US $–14,798 to 3434), with a 79.96% probability of being more effective at lower costs. Compared with G_NT, TECCU saved €2250 (US $2463) per additional patient in remission (95% CI €–15,363 to 11,086; US $–16,817 to 12,135), and G_NT saved €538 (US $589) compared with G_control (95% CI €–6475 to 5303; US $–7088 to 5805). G_TECCU and G_NT showed an 84% and 67% probability, respectively, of producing a cost saving per additional quality-adjusted life-year (QALY) compared with G_control, considering those simulations that involved negative incremental QALYs as well. CONCLUSIONS There is a high probability that the TECCU Web platform is more cost-effective than standard and telephone care in the short term. Further research considering larger cohorts and longer time horizons is required. CLINICALTRIAL ClinicalTrials.gov NCT02943538; https://clinicaltrials.gov/ct2/show/NCT02943538 (http://www. webcitation.org/746CRRtDN)

scholarly journals Telemonitoring of Crohn’s Disease and Ulcerative Colitis (TECCU): Cost-Effectiveness Analysis

10.2196/15505 ◽  
2019 ◽  
Vol 21 (9) ◽  
pp. e15505 ◽  
Author(s):  
Javier Del Hoyo ◽  
Pilar Nos ◽  
Guillermo Bastida ◽  
Raquel Faubel ◽  
Diana Muñoz ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Cost Effectiveness ◽  
Bowel Disease ◽  
Intervention Group ◽  
Additional Patient ◽  
Inflammatory Bowel ◽  
The Cost ◽  
Web Platform ◽  
Quality Adjusted Life

Background Although electronic health interventions are considered safe and efficient, evidence regarding the cost-effectiveness of telemonitoring in inflammatory bowel disease is lacking. Objective We aimed to evaluate the cost-effectiveness and cost-utility of the Telemonitorización de la Enfermedad de Crohn y Colitis Ulcerosa (Telemonitoring of Crohn’s Disease and Ulcerative Colitis [TECCU]) Web platform (G_TECCU intervention group) for telemonitoring complex inflammatory bowel disease, compared with standard care (G_control) and nurse-assisted telephone care (G_NT intervention group). Methods We analyzed cost-effectiveness from a societal perspective by comparing the 3 follow-up methods used in a previous 24-week randomized controlled trial, conducted at a tertiary university hospital in Spain. Patients with inflammatory bowel disease who initiated immunosuppressants or biologic agents, or both, to control inflammatory activity were recruited consecutively. Data on the effects on disease activity (using clinical indexes) and quality-adjusted life-years (using the EuroQol 5 dimensions questionnaire) were collected. We calculated the costs of health care, equipment, and patients’ productivity and social activity impairment. We compared the mean costs per patient, utilities, and bootstrapped differences. Results We included 63 patients (21 patients per group). TECCU saved €1005 (US $1100) per additional patient in remission compared with G_control (95% CI €–13,518 to 3137; US $–14,798 to 3434), with a 79.96% probability of being more effective at lower costs. Compared with G_NT, TECCU saved €2250 (US $2463) per additional patient in remission (95% CI €–15,363 to 11,086; US $–16,817 to 12,135), and G_NT saved €538 (US $589) compared with G_control (95% CI €–6475 to 5303; US $–7088 to 5805). G_TECCU and G_NT showed an 84% and 67% probability, respectively, of producing a cost saving per additional quality-adjusted life-year (QALY) compared with G_control, considering those simulations that involved negative incremental QALYs as well. Conclusions There is a high probability that the TECCU Web platform is more cost-effective than standard and telephone care in the short term. Further research considering larger cohorts and longer time horizons is required. Trial Registration ClinicalTrials.gov NCT02943538; https://clinicaltrials.gov/ct2/show/NCT02943538 (http://www. webcitation.org/746CRRtDN)

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