PDF(Pubmed)
Abstract：
The clinical benefits of advanced therapies (i.e., biologics and small-molecule drugs) in the treatment of moderate-to-severe ulcerative colitis (UC) have been demonstrated; however, there is less clarity regarding the economic and health-related quality of life (HRQoL) impact of these treatments. We conducted a systematic literature review to synthesize data on cost, healthcare resource utilization (HCRU), and HRQoL for patients who received approved advanced therapies for moderate-to-severe UC in the United States and Europe.
Databases including MEDLINE, Embase, the Database of Abstracts of Reviews of Effects (DARE), the National Health Service Economic Evaluation Database (NHS EED), and EconLit were searched systematically to identify observational studies published between January 1, 2010 and October 14, 2021 that assessed the impact of advanced therapies on cost, HCRU, and/or HRQoL in adults with moderate-to-severe UC. Supplementary gray literature searches of conference proceedings from the past 4 years (January 2018 to October 2021) were also performed.
47 publications of 40 unique cost/HCRU studies and 13 publications of nine unique HRQoL studies were included. Findings demonstrated that biologics have a positive impact on indirect costs (i.e., productivity, presenteeism, and absenteeism) and HRQoL. High costs of biologics were not always fully offset by reductions in cost and HCRU associated with disease management. For many patients, treatment switching and dose escalations were required, thus increasing drug costs, particularly when switching across treatment classes.
These findings highlight a high unmet need for therapies for moderate-to-severe UC that can reduce the healthcare burden and impact on society. Further research is warranted, as the reported evidence was limited by the small sample sizes of some treatment groups within a study.
Although advanced therapies, such as biologics and small-molecule drugs, have shown clinical benefit in treating moderate-to-severe ulcerative colitis, their economic impact and effect on patients’ quality of life is less clear. This study comprehensively reviewed the cost and use of healthcare resources associated with starting treatment with advanced therapies for ulcerative colitis, as well as the impact of these treatments on quality of life. We found that while biologics have a benefit on work productivity, work attendance, work absence, and quality of life, the high costs of biologics were not always fully met by reductions in disease management costs and healthcare resources. Many patients needed to switch treatments or required dose increases, which were expensive. There is a high unmet need for therapies for moderate-to-severe ulcerative colitis that can reduce healthcare costs, use of healthcare resources, and effect on society.
Databases including MEDLINE, Embase, the Database of Abstracts of Reviews of Effects (DARE), the National Health Service Economic Evaluation Database (NHS EED), and EconLit were searched systematically to identify observational studies published between January 1, 2010 and October 14, 2021 that assessed the impact of advanced therapies on cost, HCRU, and/or HRQoL in adults with moderate-to-severe UC. Supplementary gray literature searches of conference proceedings from the past 4 years (January 2018 to October 2021) were also performed.
47 publications of 40 unique cost/HCRU studies and 13 publications of nine unique HRQoL studies were included. Findings demonstrated that biologics have a positive impact on indirect costs (i.e., productivity, presenteeism, and absenteeism) and HRQoL. High costs of biologics were not always fully offset by reductions in cost and HCRU associated with disease management. For many patients, treatment switching and dose escalations were required, thus increasing drug costs, particularly when switching across treatment classes.
These findings highlight a high unmet need for therapies for moderate-to-severe UC that can reduce the healthcare burden and impact on society. Further research is warranted, as the reported evidence was limited by the small sample sizes of some treatment groups within a study.
Although advanced therapies, such as biologics and small-molecule drugs, have shown clinical benefit in treating moderate-to-severe ulcerative colitis, their economic impact and effect on patients’ quality of life is less clear. This study comprehensively reviewed the cost and use of healthcare resources associated with starting treatment with advanced therapies for ulcerative colitis, as well as the impact of these treatments on quality of life. We found that while biologics have a benefit on work productivity, work attendance, work absence, and quality of life, the high costs of biologics were not always fully met by reductions in disease management costs and healthcare resources. Many patients needed to switch treatments or required dose increases, which were expensive. There is a high unmet need for therapies for moderate-to-severe ulcerative colitis that can reduce healthcare costs, use of healthcare resources, and effect on society.
摘要：
背景：先进疗法的临床益处（即已证明生物制剂和小分子药物）可用于治疗中度至重度溃疡性结肠炎（UC）；然而，这些治疗对经济和健康相关生活质量(HRQoL)的影响尚不明确.我们进行了系统的文献综述，以综合成本数据，医疗保健资源利用(HCCU)，和HRQoL在美国和欧洲接受中重度UC批准的高级治疗的患者。
方法：包括MEDLINE、Embase,效果评论摘要数据库(DARE)，国家卫生服务经济评价数据库(NHSEED)，和EconLit进行了系统搜索，以确定2010年1月1日至2021年10月14日之间发表的观察性研究，这些研究评估了先进疗法对成本的影响，HCCU,和/或成人中度至重度UC的HRQoL。还对过去4年（2018年1月至2021年10月）的会议记录进行了补充灰色文献检索。
结果：纳入了40项独特成本/HCRU研究的47篇出版物和9项独特HRQoL研究的13篇出版物。研究结果表明，生物制品对间接成本有积极影响(即，生产力,presenteism,和旷工)和HRQoL。生物制剂的高成本并不总是被成本的降低和与疾病管理相关的HCCU完全抵消。对于许多患者来说，需要进行治疗切换和剂量递增，从而增加药物成本，特别是在跨治疗类别切换时。
结论：这些发现强调了对中重度UC治疗的高度未满足的需求，可以减轻医疗负担和对社会的影响。需要进一步的研究,因为报告的证据受到研究中某些治疗组样本量小的限制.
虽然先进的疗法，如生物制剂和小分子药物，在治疗中度至重度溃疡性结肠炎方面已显示出临床益处，它们的经济影响和对患者生活质量的影响尚不清楚。本研究全面回顾了与溃疡性结肠炎的先进疗法开始治疗相关的医疗保健资源的成本和使用情况。以及这些治疗对生活质量的影响。我们发现，虽然生物制剂对工作效率有好处，出勤,工作缺勤,和生活质量，生物制剂的高成本并不总是能够通过减少疾病管理成本和医疗资源来满足.许多患者需要转换治疗或需要增加剂量，这是昂贵的。对中度至重度溃疡性结肠炎的治疗有很高的未满足需求，可以降低医疗成本，利用医疗保健资源，以及对社会的影响。
方法：包括MEDLINE、Embase,效果评论摘要数据库(DARE)，国家卫生服务经济评价数据库(NHSEED)，和EconLit进行了系统搜索，以确定2010年1月1日至2021年10月14日之间发表的观察性研究，这些研究评估了先进疗法对成本的影响，HCCU,和/或成人中度至重度UC的HRQoL。还对过去4年（2018年1月至2021年10月）的会议记录进行了补充灰色文献检索。
结果：纳入了40项独特成本/HCRU研究的47篇出版物和9项独特HRQoL研究的13篇出版物。研究结果表明，生物制品对间接成本有积极影响(即，生产力,presenteism,和旷工)和HRQoL。生物制剂的高成本并不总是被成本的降低和与疾病管理相关的HCCU完全抵消。对于许多患者来说，需要进行治疗切换和剂量递增，从而增加药物成本，特别是在跨治疗类别切换时。
结论：这些发现强调了对中重度UC治疗的高度未满足的需求，可以减轻医疗负担和对社会的影响。需要进一步的研究,因为报告的证据受到研究中某些治疗组样本量小的限制.
虽然先进的疗法，如生物制剂和小分子药物，在治疗中度至重度溃疡性结肠炎方面已显示出临床益处，它们的经济影响和对患者生活质量的影响尚不清楚。本研究全面回顾了与溃疡性结肠炎的先进疗法开始治疗相关的医疗保健资源的成本和使用情况。以及这些治疗对生活质量的影响。我们发现，虽然生物制剂对工作效率有好处，出勤,工作缺勤,和生活质量，生物制剂的高成本并不总是能够通过减少疾病管理成本和医疗资源来满足.许多患者需要转换治疗或需要增加剂量，这是昂贵的。对中度至重度溃疡性结肠炎的治疗有很高的未满足需求，可以降低医疗成本，利用医疗保健资源，以及对社会的影响。
