Treatment cost of ulcerative colitis: Is apheresis with Adacolumn® cost-effective?

BackgroundScarce data are available in Europe on the cost of treatment for ulcerative colitis (UC).AimTo assess the cost of illness of moderate-to-severe UC in two scenarios: traditional treatment versus alternative treatment incorporating granulocyte, monocyte adsorption – apheresis (GMA-Apheresis; Adacolumn®). To determine the relative cost-effectiveness of both options in steroid-dependent patients.MethodsOne-year cost-of-illness and cost-effectiveness analysis from the third-payer perspective using a decision tree model was carried out. Probabilities of each event were derived from the literature and an expert panel. Direct medical costs were obtained from official sources (€2004). Effectiveness was measured by the proportion of patients achieving clinical remission.ResultsThe average annual cost per patient treated with traditional treatment was estimated to be €6740; with GMA-Apheresis, the cost was estimated to be €6959. In steroid-dependent patients, the average annual cost was €6059 and €11,436, respectively. The proportion of patients achieving clinical remission with GMA-Apheresis was 22.5% higher. As second- and third-line therapy, a new course of corticosteroids and surgery was avoided in 18.5 and 4% of patients, respectively.ConclusionsIncorporating GMA-Apheresis (Adacolumn®) in the therapeutic management of moderate-to-severe UC patients is cost-effective and implies savings related to the reduction of adverse effects derived from corticosteroid use and to the decreased number of surgical interventions.