Evidence map›Paper›PMID 39724469›Full record

ArticleDigestive diseases and sciences2025

Therapeutic Drug Monitoring in Patients with Ulcerative Colitis on Infliximab: A Cost-Effectiveness Analysis.

Paul Dupenloup, Margaret Zhou, Matthew P Dizon, Aadit P Shah, Jeremy D Goldhaber-Fiebert, Douglas K Owens, Sarah E Streett, Margaret L Brandeau, Grant E Barber

Abstract read
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Article in Digestive diseases and sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Trial
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Paul DupenloupDepartment of Management Science and Engineering, Huang Engineering Center, Stanford University, 475 Via Ortega, Mail Code: 4026, Stanford, CA, 94305, USA. pdupenlp@stanford.edu.
Margaret ZhouDivision of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, USA.
Matthew P DizonDepartment of Health Policy, Stanford University School of Medicine, Stanford, CA, USA.
Aadit P ShahStanford University School of Medicine, Stanford, CA, USA.
Jeremy D Goldhaber-FiebertDepartment of Health Policy, Stanford University School of Medicine, Stanford, CA, USA.
Douglas K OwensDepartment of Health Policy, Stanford University School of Medicine, Stanford, CA, USA.
Sarah E StreettDivision of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, USA.
Margaret L BrandeauDepartment of Management Science and Engineering, Huang Engineering Center, Stanford University, 475 Via Ortega, Mail Code: 4026, Stanford, CA, 94305, USA.
Grant E BarberDivision of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsUlcerative colitis (UC) can be treated with infliximab (IFX). Therapeutic drug monitoring (TDM) can yield superior outcomes, but its cost-effectiveness is unknown.

methodsWe used a decision analytic Markov model to conduct a cost-effectiveness analysis comparing proactive TDM, reactive TDM, no TDM, and combinations of proactive and reactive TDM in 25-year-old patients with UC started on IFX. Under proactive TDM, IFX concentration and anti-drug antibodies were measured every 6 months and during a flare; under reactive TDM, these were only measured during a flare. Patients with flares experienced decreased quality of life (QoL) and risked further complications. We evaluated lifetime costs (2021 U.S. dollars), quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios, all discounted at 3% annually, from a healthcare sector perspective. We performed probabilistic sensitivity analysis (PSA) and deterministic sensitivity analyses. We used a willingness-to-pay threshold of $100,000 per QALY gained.

resultsAll TDM strategies increased QALYs and healthcare costs. Compared to no TDM, reactive TDM increased costs from $496,700 to $497,500 ($3,200 per QALY gained). 1 year of proactive TDM followed by reactive TDM increased costs to $508,600 ($63,800 per QALY gained relative to reactive TDM). In 46% of PSA samples, 1 year of proactive TDM followed by reactive TDM was most likely to be the optimal strategy. This strategy was less likely to be cost-effective when remission QoL was lower and when post-surgical QoL was higher.

conclusion1 year of proactive TDM followed by reactive TDM is cost-effective in patients with UC on IFX.

Indexed as

Colitis, UlcerativeDrug MonitoringGastrointestinal AgentsInfliximabAdultCost-Benefit AnalysisCost-Effectiveness AnalysisFemaleHumansMaleMarkov ChainsQuality-Adjusted Life YearsQuality of LifeGastrointestinal AgentsInfliximabBiologicsCost-effectivenessHealth economicsTherapeutic drug monitoringUlcerative colitis

Identifiers

PMID39724469

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Registered trials

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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.