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Health Care Costs of Complex Perianal Fistula in Crohn’s Disease

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Abstract

Aim

To evaluate the use of health care resources and the associated costs of complex perianal Crohn’s disease (CD) from the National Health System perspective.

Methods

We conducted a multicenter, retrospective, observational study in which gastroenterologists from 11 hospitals in the Community of Madrid took part. Data was collected on the direct healthcare resources (pharmacological treatments, surgical procedures, laboratory/diagnostic tests, visits to specialists and emergency departments, and hospitalizations) consumed by 97 adult patients with complex perianal CD which was active at some point between January 1, 2005, and case history review.

Results

We recorded 527 treatments: 73.1 % pharmacological (32.3 % antibiotic, 20.5 % immunomodulator, 20.3 % biological) and 26.9 % surgical. Mean annual global cost was €8,289/patient, 75.3 % (€6,242) of which was accounted for by pharmacological treatments (€13.44 antibiotics; €1,136 immunomodulators; €5,093 biological agents), 12.4 % (€1,027) by hospitalizations and surgery, 7.7 % (€640) by medical visits, 4.2 % (€350) by laboratory/diagnostic tests, and 0.4 % (€30) by emergency department visits.

Conclusions

Pharmacological therapies, and in particular biological agents, are the main cost driver in complex perianal CD; costs due to surgery and hospitalizations are much lower.

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Acknowledgments

The authors thank Cellerix, S.A. [grupo Tigenix] and IMS Consulting Group for their support in this study. The project was funded by Cellerix, S.A., which is now part of the TiGenix (Spain) group. The study was designed and conducted independently by the authors. All authors had access to the data and decided to jointly submit the manuscript.

Conflict of interest

M. Chaparro has served as a speaker and has received research funding from MSD and Abbvie. J.P. Gisbert has served as a speaker, a consultant and an advisory board member and has received research funding from MSD and Abbvie. I. Marín-Jiménez has served as speaker, consultor and has received research funding from MSD y Abbvie. A. Algaba has received a research grant from MSD. C. Taxonera has served as a speaker, consultant or advisory for MSD, Abbvie and Cellerix. B. Botella, C. Yela, P. López, C. Zanotti, P. Burgueño, F. Bermejo, R. Pajares, M.D. Martín, A. Ponferrada, L. Pérez, M. Calvo, J. Orofino, N. Lara, M. García-Losa, X. Badia, B. Casis, J. Maté and I. Vera have nothing to declare.

Author information

Authors and Affiliations

  1. Servicio de Aparato Digestivo del Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IP), Playa de Mojácar 29. Urb Bonanza, 28669, Boadilla del Monte, Madrid, Spain

    M. Chaparro, P. Burgueño, J. Maté & J. P. Gisbert

  2. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain

    M. Chaparro, J. Maté & J. P. Gisbert

  3. Cellerix, S.A., Madrid, Spain

    C. Zanotti & J. Orofino

  4. Servicio de Aparato Digestivo del Hospital Puerta de Hierro, Madrid, Spain

    I. Vera & M. Calvo

  5. Servicio de Aparato Digestivo del Hospital Universitario de Fuenlabrada, Madrid, Spain

    F. Bermejo & A. Algaba

  6. Servicio de Aparato Digestivo del Hospital Gregorio Marañón, Madrid, Spain

    I. Marín-Jiménez & L. Pérez

  7. Servicio de Aparato Digestivo del Hospital Doce de Octubre, Madrid, Spain

    C. Yela & B. Casis

  8. Servicio de Aparato Digestivo del Hospital de Alcorcón, Madrid, Spain

    P. López

  9. Servicio de Aparato Digestivo del Hospital de La Paz, Madrid, Spain

    M. D. Martín

  10. Servicio de Aparato Digestivo del Hospital Clínico San Carlos, Madrid, Spain

    C. Taxonera

  11. Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain

    C. Taxonera

  12. Servicio de Aparato Digestivo del Hospital de Infanta Cristina, Madrid, Spain

    B. Botella

  13. Servicio de Aparato Digestivo del Hospital de Infanta Sofía, Madrid, Spain

    R. Pajares

  14. Servicio de Aparato Digestivo del Hospital de Infanta Leonor, Madrid, Spain

    A. Ponferrada

  15. IMS Health, Barcelona, Spain

    N. Lara, M. García-Losa & X. Badia

Authors
  1. M. Chaparro
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  2. C. Zanotti
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  3. P. Burgueño
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  4. I. Vera
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  5. F. Bermejo
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  6. I. Marín-Jiménez
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  7. C. Yela
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  8. P. López
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  9. M. D. Martín
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  10. C. Taxonera
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  11. B. Botella
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  12. R. Pajares
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  13. A. Ponferrada
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  14. M. Calvo
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  15. A. Algaba
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  16. L. Pérez
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  17. B. Casis
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  18. J. Maté
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  19. J. Orofino
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  20. N. Lara
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  21. M. García-Losa
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  22. X. Badia
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  23. J. P. Gisbert
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Corresponding author

Correspondence to M. Chaparro.

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Chaparro, M., Zanotti, C., Burgueño, P. et al. Health Care Costs of Complex Perianal Fistula in Crohn’s Disease. Dig Dis Sci 58, 3400–3406 (2013). https://doi.org/10.1007/s10620-013-2830-7

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  • DOI: https://doi.org/10.1007/s10620-013-2830-7

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