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.

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.