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17.05.2019 | Original Paper Open Access

Patient and general population values for luminal and perianal fistulising Crohn’s disease health states

The European Journal of Health Economics
Fanni Rencz, Peep F. M. Stalmeier, Márta Péntek, Valentin Brodszky, Gábor Ruzsa, Lóránt Gönczi, Károly Palatka, László Herszényi, Eszter Schäfer, János Banai, Mariann Rutka, László Gulácsi, Peter L. Lakatos
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The online version of this article (https://​doi.​org/​10.​1007/​s10198-019-01065-y) contains supplementary material, which is available to authorized users.
László Gulácsi and Peter L. Lakatos have equally contributed to this work.

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In patients with Crohn’s disease (CD), luminal disease activity paralleled by perianal fistulas may seriously impair health-related quality of life (HRQoL). Health utility values are not available from patients with CD that reflect the health loss associated with both luminal and perianal CD.


To generate utilities for luminal and concomitant perianal fistulising CD health states directly from patients and from members of the general public.


A cross-sectional survey was undertaken enrolling CD patients and a convenience sample of members of the general population. Respondents were asked to evaluate four common CD heath states [severe luminal disease (sCD), mild luminal disease (mCD), severe luminal disease with active perianal fistulas (sPFCD), and mild luminal disease with active perianal fistulas (mPFCD)] by 10-year time trade-off (TTO). In addition, patients assessed their current HRQoL by the TTO method.


Responses of 206 patients (40.8% with perianal fistulas) and 221 members of the general population were analysed. Mean ± SD utilities among patients for sPFCD, sCD, mPFCD and mCD states were 0.69 ± 0.33, 0.73 ± 0.31, 0.80 ± 0.29 and 0.87 ± 0.26. Corresponding values in the general public were: 0.59 ± 0.31, 0.65 ± 0.29, 0.80 ± 0.26 and 0.88 ± 0.25. Patients with active perianal fistulas, previous non-resection surgeries, and higher pain intensity scores valued their current health as worse (p < 0.05).


TTO is a feasible method to assess HRQoL in patients with perianal fistulising disease, often not captured by health status questionnaires. Utilities from this study are intended to support the optimization of treatment-related decision making in patients with luminal disease paralleled by active perianal fistulas.

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Supplementary material 2 (PDF 231 kb)
Supplementary material 3 (PDF 234 kb)
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