Journal of medical economics · 2025
Assessment of healthcare resource utilization and direct medical cost in relation to treatment length of oral corticosteroids in biologic-initiated patients with ulcerative colitis: a Japanese claims database study.
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Miyazaki Celine, Inoue Tomoyuki, Sugimoto Shinya, Yoshigoe Shinichi, Li Nan
Аннотация
BACKGROUND: Ulcerative colitis (UC) imposes persistent clinical and economic burden on patient and healthcare management in Japan.
PURPOSE: To evaluate impact of prolonged oral corticosteroid (OC) use on healthcare resource utilization (HCRU) and treatment-related costs, and to assess discontinuation patterns of 5-amino salicylic acid (5-ASA), immunomodulators (IMs), and OCs in Japanese UC patients after biologic initiation.
METHODS: Data were extracted from the Japan Medical Data Centre for patients diagnosed with UC with ≥1 prescription of OC with 5-ASA and/or IM, prior or at the index date (first biologic initiation) between 2016 and 2022, grouped by </≥180 days of OC use, and analyzed using descriptive statistics, Kaplan-Meier and linear regression.
RESULTS: For all identified patients (N = 1,494; mean ± SD age: 38.6 ± 13.7 years; male: 65.3%), HCRU (inpatient and outpatient visits, length of stay, and procedures) per patient-year (PPY) declined after biologics initiation. Direct inpatient medical costs decreased throughout the study; outpatient costs increased from pre-index to the 1-year post-index period, followed by slight decrease in the 2-year and 3-year post-index. PPY costs of non-biologic UC-related drugs (OCs, 5-ASA, IMs) increased slightly during the post-index period. Overall, HCRU and costs dynamics were similar in patients with <180 days and those with ≥180 days of OC use. Patients with <180 days of OC use had shorter median time to OC discontinuation after biologic initiation compared with ≥180 days group (3.1 months vs 9.5 months).
CONCLUSIONS: Biologic initiation was associated with reduced HCRU and inpatient costs, with similar trends observed regardless of prolonged or shorter OC use duration.
PURPOSE: To evaluate impact of prolonged oral corticosteroid (OC) use on healthcare resource utilization (HCRU) and treatment-related costs, and to assess discontinuation patterns of 5-amino salicylic acid (5-ASA), immunomodulators (IMs), and OCs in Japanese UC patients after biologic initiation.
METHODS: Data were extracted from the Japan Medical Data Centre for patients diagnosed with UC with ≥1 prescription of OC with 5-ASA and/or IM, prior or at the index date (first biologic initiation) between 2016 and 2022, grouped by </≥180 days of OC use, and analyzed using descriptive statistics, Kaplan-Meier and linear regression.
RESULTS: For all identified patients (N = 1,494; mean ± SD age: 38.6 ± 13.7 years; male: 65.3%), HCRU (inpatient and outpatient visits, length of stay, and procedures) per patient-year (PPY) declined after biologics initiation. Direct inpatient medical costs decreased throughout the study; outpatient costs increased from pre-index to the 1-year post-index period, followed by slight decrease in the 2-year and 3-year post-index. PPY costs of non-biologic UC-related drugs (OCs, 5-ASA, IMs) increased slightly during the post-index period. Overall, HCRU and costs dynamics were similar in patients with <180 days and those with ≥180 days of OC use. Patients with <180 days of OC use had shorter median time to OC discontinuation after biologic initiation compared with ≥180 days group (3.1 months vs 9.5 months).
CONCLUSIONS: Biologic initiation was associated with reduced HCRU and inpatient costs, with similar trends observed regardless of prolonged or shorter OC use duration.