{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T10:41:19Z","timestamp":1761561679611,"version":"build-2065373602"},"reference-count":59,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2012,4,23]],"date-time":"2012-04-23T00:00:00Z","timestamp":1335139200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2012,6]]},"abstract":"<jats:sec><jats:title>Study Objective<\/jats:title><jats:p>To compare the cost versus utility of four guideline\u2010recommended biologic treatments\u2014infliximab, adalimumab, certolizumab pegol, and natalizumab\u2014for the treatment of Crohn's disease from a United States payer perspective.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Cost\u2010utility decision analytic model using a Monte Carlo simulation of 10,000 cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Source<\/jats:title><jats:p>Published primary and tertiary literature.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>Patients with moderate\u2010to\u2010severe Crohn's disease, as categorized by the Crohn's Disease Activity Index, that failed to respond to standard therapy and who were treatment naive to biologics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements and Main Results<\/jats:title><jats:p>The decision analytic model base case was a 35\u2010year\u2010old patient weighing 70 kg with moderate\u2010to\u2010severe Crohn's disease. Therapeutic efficacy data were obtained from published clinical trials. Online prescription drug, hospitalization data, and Current Procedural Terminology codes were used to estimate cost. Utility measures were estimated using published data obtained from patients with Crohn's disease. The time end point used for the model was 54\u00a0weeks. The analysis demonstrated considerable overlap in quality\u2010adjusted life years gained with the four agents (i.e., mean values across four treatments\u00a00.79\u20120.80). Although infliximab had the lowest median cost, there was overlap in the 95% confidence intervals (CIs) compared with the other three biologic products: mean (95% CI) cost for infliximab $22,663 ($19,105\u201226,433), adalimumab $27,515 ($23,796\u201231,584), certolizumab pegol $29,062 ($24,952\u201233,882), and natalizumab $31,166 ($25,915\u201237,195). However, the cost\u2010effectiveness acceptability curve demonstrated that infliximab had the most scenarios (95.2%) when it was the most cost\u2010effective biologic therapy using a willingness\u2010to\u2010pay threshold of $100,000\/quality\u2010adjusted life years gained.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients with moderate\u2010to\u2010severe Crohn's disease that failed to respond to standard treatment should preferentially receive infliximab as their initial biologic treatment, since this agent had the highest probability of being the most cost\u2010effective therapy compared with the other biologic treatment options.<\/jats:p><\/jats:sec>","DOI":"10.1002\/j.1875-9114.2011.01053.x","type":"journal-article","created":{"date-parts":[[2012,9,5]],"date-time":"2012-09-05T03:54:49Z","timestamp":1346817289000},"page":"515-526","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Cost\u2010Utility Analysis of Biologic Treatments for Moderate\u2010to\u2010Severe Crohn's Disease"],"prefix":"10.1002","volume":"32","author":[{"given":"Derek H.","family":"Tang","sequence":"first","affiliation":[{"name":"Department of Pharmaceutical Sciences University of Arizona College of Pharmacy Tucson Arizona"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward P.","family":"Armstrong","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice and Science University of Arizona College of Pharmacy Tucson Arizona"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeannie K.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice and Science University of Arizona College of Pharmacy Tucson Arizona"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,4,23]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2004.041616"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.3780030405"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1185\/030079908X260790"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-009-0057-3"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.20029"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-2980.2008.00355.x"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-008-0429-1"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2007.03276.x"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.21007"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2008.168"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.2165\/11312710-000000000-00000"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.21048"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa054693"},{"key":"e_1_2_6_15_1","unstructured":"U.S. Food and Drug Administration.Tysabri (natalizumab): Update of healthcare professional information 2011. 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