ArticleThe European journal of health economics : HEPAC : health economics in prevention and care2019
Costs of dose escalation among ulcerative colitis patients treated with adalimumab in Germany.
Article in The European journal of health economics : HEPAC : health economics in prevention and care, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
8 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- A Systematic Review of the Economic and Health-Related Quality of Life Impact of Advanced Therapies Used to Treat Moderate-to-Severe Ulcerative Colitis.Advances in therapy · 2023Pooled it
- Dose Escalation Patterns of Advanced Therapies in Crohn's Disease and Ulcerative Colitis: A Systematic Literature Review.Advances in therapy · 2023Pooled it
- Dose Escalation Patterns and Associated Costs of Advanced Therapies for Ulcerative Colitis in France and the United Kingdom: A Retrospective Database Analysis.ClinicoEconomics and outcomes research : CEOR · 2025Article
- Dose Escalation of Biologics in Biologic-Naïve Patients With Ulcerative Colitis: Outcomes From the ODESSA-UC Study.Crohn's & colitis 360 · 2023Article
- Rates of clinical remission and inadequate response to advanced therapies among patients with ulcerative colitis in Germany.International journal of colorectal disease · 2023Article
- Systematic Literature Review of Real-World Evidence on Dose Escalation and Treatment Switching in Ulcerative Colitis.ClinicoEconomics and outcomes research : CEOR · 2023Review
- Frequency and Effectiveness of Empirical Anti-TNF Dose Intensification in Inflammatory Bowel Disease: Systematic Review with Meta-Analysis.Journal of clinical medicine · 2021Review
- Maneuvering Clinical Pathways for Ulcerative Colitis.Current gastroenterology reports · 2019Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsWe determined adalimumab utilisation and associated drug costs in patients with ulcerative colitis (UC), focusing on patients requiring dose escalation.
methodsThe retrospective cohort study analysed the de-identified prescription data of the Arvato Health Analytics (Munich, Germany) database (2010-2015) in adult UC patients undergoing adalimumab therapy.
resultsA total of 154 patients were newly treated with adalimumab (average 39.6 years, 53% females), with a mean dose of 2.93 mg/day. Within 12 months, 69 patients (45%) received a dose increase of > 50% (doubled dose in 48 patients; 32%), with the escalation reported at 169.3 ± 99.3 days. A subsequent dose de-escalation to the standard dose occurred in 50 (32%) of patients that initially had a dose increase of > 50% (after 94.7 ± 49.6 days). Direct drug costs were 28,846 € in the overall study population, 24,934 € in patients on standard dose, 36,094 € in patients with dose increase, and 32,742 € in patients with increase and subsequent decrease.
conclusionDose escalation occurred frequently, and in one third of patients the dose was at least doubled. Dose escalations were associated with substantial increases in direct drug costs. Dose escalation of adalimumab can severely affect both the health care system and the drug budget of the physician. It needs to be considered that other biologic medications may constitute a more cost-effective alternative.
Indexed as
Identifiers
29362899What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.