Preemptive Dose Optimization Using Therapeutic Drug Monitoring for Biologic Therapy of Crohn’s Disease: Avoiding Failure While Lowering Costs?

Excerpt

Crohn’s disease is associated with a high economic burden to society due to healthcare costs and productivity losses, of which, before the introduction of antitumor necrosis factor (TNF) therapy, half were driven by surgical and medical hospitalization, with decreased work productivity accounting for almost 50 % of total costs in Europe [1]. Since the introduction of biologicals, the traditional cost profile has changed: A recent cost-of-illness study analyzing healthcare costs and productivity losses in the Netherlands concluded that although total healthcare costs in Crohn’s disease patients were stable, medication costs increased to 71 % of total healthcare costs, whereas hospitalization decreased to 19 % and surgery to <1 % [1]. Productivity losses due to sick leave decreased to 16 % of total costs in Crohn’s disease. Even though healthcare costs between Europe and the USA differ to a large extent, comparable trends have been reported [2, 3]. Biologic therapy should be optimized early in the course of Crohn’s disease due to the need for long-term treatment with few available alternatives. …