ArticleUnited European gastroenterology journal2018
Cost-effectiveness of biological treatment sequences for fistulising Crohn's disease across Europe.
Article in United European gastroenterology journal, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
What it found
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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.
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Who cites it
16 citing papers in PubMed, 28 citations in OpenAlex.
- Cost-Utility Analysis of Treatment Sequences for Moderate-to-Severe Crohn's Disease.PharmacoEconomics · 2025Article
- Efficacy, Safety, and Cost-Effectiveness of the Infliximab Biosimilar GP-1111 in Patients with Inflammatory Bowel Disease Who Underwent a Nonmedical Switch: A Prospective Cohort Study.Biologics : targets & therapy · 2025Article
- Cost Effectiveness of Sequencing Vedolizumab as First-Line Biologic in Ulcerative Colitis and Crohn's Disease in Canada: An Analysis Using Real-World Evidence from the EVOLVE Study.PharmacoEconomics - open · 2025Article
- Patients' Perspectives, Experiences, and Concerns With Perianal Fistulae: Insights From Online Targeted-Disease Forums.Crohn's & colitis 360 · 2023Article
- Cost-effectiveness Analysis of Subcutaneous Infliximab for Inflammatory Bowel Diseases in Sequential Biologic Treatment.Inflammatory bowel diseases · 2023Article
- Technological Advancements in Monoclonal Antibodies.TheScientificWorldJournal · 2021Review
- Identification of the Most Cost-effective Position of Vedolizumab Among the Available Biologic Drugs for the Treatment of Ulcerative Colitis.Journal of Crohn's & colitis · 2020Article
- Identifying Key Benefits in European Off-Patent Biologics and Biosimilar Markets: It is Not Only About Price!BioDrugs : clinical immunotherapeutics, biopharmaceuticals and gene therapy · 2020Review
- Biosimilars: concept, current status, and future perspectives in inflammatory bowel diseases.Intestinal research · 2020Review
- Article
- Long-term implications of structured transition of adolescents with inflammatory bowel disease into adult health care: a retrospective study.BMC gastroenterology · 2019Article
- Patient and general population values for luminal and perianal fistulising Crohn's disease health states.The European journal of health economics : HEPAC : health economics in prevention and care · 2019Article
- Article
- Validity of the EQ-5D-5L and EQ-5D-3L in patients with Crohn's disease.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2019Article
- Cost-Effectiveness Analysis of Crohn's Disease Treatment with Vedolizumab and Ustekinumab After Failure of Tumor Necrosis Factor-α Antagonist.PharmacoEconomics · 2018Article
- Infliximab Pricing in International Economic Evaluations in Inflammatory Bowel Disease to Inform Biologic and Biosimilar Access Policies: A Systematic Review.MDM policy & practiceReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 6 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn clinical practice, treatment sequences of biologicals are applied for active fistulising Crohn's disease, however underlying health economic analyses are lacking.
objectiveThe purpose of this study was to analyse the cost-effectiveness of different biological sequences including infliximab, biosimilar-infliximab, adalimumab and vedolizumab in nine European countries.
methodsA Markov model was developed to compare treatment sequences of one, two and three biologicals from the payer's perspective on a five-year time horizon. Data on effectiveness and health state utilities were obtained from the literature. Country-specific costs were considered. Calculations were performed with both official list prices and estimated real prices of biologicals.
resultsBiosimilar-infliximab is the most cost-effective treatment against standard care across the countries (with list prices: €34684-€72551/quality adjusted life year; with estimated real prices: €24364-€56086/quality adjusted life year). The most cost-effective two-agent sequence, except for Germany, is the biosimilar-infliximab-adalimumab therapy compared with single biosimilar-infliximab (with list prices: €58533-€133831/quality adjusted life year; with estimated prices: €45513-€105875/quality adjusted life year). The cost-effectiveness of the biosimilar-infliximab-adalimumab-vedolizumab three-agent sequence compared wit biosimilar-infliximab -adalimumab is €87214-€152901/quality adjusted life year.
conclusionsThe suggested first-choice biological treatment is biosimilar-infliximab. In case of treatment failure, switching to adalimumab then to vedolizumab provides meaningful additional health gains but at increased costs. Inter-country differences in cost-effectiveness are remarkable due to significant differences in costs.
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Registered trials
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