Healthcare resource utilization following ustekinumab initiation among bio-naïve Canadian patients with moderately-to-severely active Crohn's disease

Dig Liver Dis. 2024 Oct;56(10):1690-1697. doi: 10.1016/j.dld.2024.04.017. Epub 2024 May 31.

Abstract

Background/aims: Real-world healthcare resource utilization (HCRU) of bio-naïve patients with Crohn's disease (CD) receiving ustekinumab was assessed.

Methods: A multicentre, retrospective chart review study of bio-naïve Canadian adult patients with moderately-to-severely active CD treated with ustekinumab was conducted. CD-related HCRU (i.e., surgery, hospitalization, or emergency room [ER] visits) was evaluated at Months 4, 6, and 12 post-ustekinumab initiation, and associated costs were sourced from a provincial database. Proportion of patients with HCRU events and ustekinumab persistence were summarized at each timepoint. Paired analysis compared HCRU events and associated costs incurred by the same patient whilst in remission vs. when not in remission.

Results: By Month 12, 11.1 % (17/153) of patients had record(s) of any CD-related HCRU event, with ER visits being the most common (7.7 %; 12/155). Hospitalization had the highest average cost (CAD $436.10; SD $2,089.25) across all patients, accounting for 82.2 % of the mean total annual cost/patient (CAD $530.47; SD $2,229.92). While in remission, ≤5 % of patients experienced some healthcare encounter, compared with 7 % when not in remission (P = 0.289). Finally, 93.5 % of patients persisted on ustekinumab at Month 12.

Conclusions: HCRU rates and associated total annual costs were lower for bio-naïve CD patients receiving ustekinumab, and when patients were in remission. Most patients continued with ustekinumab at Month 12.

Keywords: Crohn's disease; Real-world study; Ustekinumab.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Canada
  • Crohn Disease* / drug therapy
  • Crohn Disease* / economics
  • Female
  • Health Resources / economics
  • Health Resources / statistics & numerical data
  • Hospitalization* / economics
  • Hospitalization* / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care / statistics & numerical data
  • Remission Induction
  • Retrospective Studies
  • Severity of Illness Index
  • Ustekinumab* / economics
  • Ustekinumab* / therapeutic use

Substances

  • Ustekinumab