A Care Pathway for the Treatment of IBD Reduces Healthcare Costs and Is Cost-Effective: Results of the Multicentre IBD Value Study.

BACKGROUND

An advanced therapy care pathway (ACP) for the treatment of patients with IBD can reduce practice variation and improve outcomes.

AIMS: This study aimed to estimate the effect of the ACP on costs and quality of life, and to assess the cost-effectiveness of the ACP.

METHODS

A cost-utility and cost-effectiveness analysis was conducted from a societal perspective. The ACP was implemented in six hospitals, and two hospitals in the same region served as controls. Costs and quality of life were assessed during a baseline period (December 2020-December 2021) and an intervention period after implementing the ACP (March 2022-March 2023). Quality-adjusted life years (QALYs) were derived from the EQ-5D-5L; disease control from the IBD-Control questionnaire. A difference-in-differences (DiD) analysis was conducted, and the net monetary benefit and incremental cost-effectiveness ratio (ICER) were calculated.

RESULTS

In total, 1,173 patients were included (intervention n = 841, control n = 332). Baseline costs per patient were €23,259.96 in the intervention hospitals and €22,837.93 in the control hospitals. During the intervention period, costs decreased to €20,959.76 in intervention hospitals. This reduction was not observed in control hospitals (€22,191.21). The DiD-analysis showed cost savings of -€1933.69; QALYs (0.001) and disease control (0.15) did not change. The ICER indicated cost savings without compromising quality of life or disease control.

CONCLUSIONS

The implementation of an ACP for the treatment of patients with IBD reduces costs, maintains quality of life and disease control, and is cost-effective. These results emphasise that the implementation of care pathways in current practices should be considered.

TRIAL REGISTRATION NUMBER: NL-OMON21751. Website: Value-based healthcare for Inflammatory Bowel Disease: Improving (cost-) effectiveness.