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A claims‐based Markov model for Crohn’s disease
Author(s) -
Malone D. C.,
Waters H. C.,
Van Den Bos J.,
Popp J.,
Draaghtel K.,
Rahman M. I.
Publication year - 2010
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2010.04356.x
Subject(s) - medicine , fulminant , crohn's disease , disease , quality adjusted life year , pediatrics , cost effectiveness , risk analysis (engineering)
Aliment Pharmacol Ther 2010; 32: 448–458 Summary Background Crohn’s disease is a chronic condition that often presents in early adulthood. Aim To evaluate health care costs and costs per quality‐adjusted life year (QALY) for Crohn’s disease. Methods A Markov model was developed using administrative claims data for patients aged ≥ 18 years with ≥ 3 years of continuous enrolment from 2000 to 2008 and ≥2 Crohn’s disease claims. Disease states (remission, mild–moderate, moderate–severe, and severe–fulminant) were defined using the American College of Gastroenterology treatment guidelines criteria. Transition probabilities were calculated from consecutive 6‐month periods. Costs were determined from paid claims and QALY utilities were obtained from the literature. The model assumed a 30‐year‐old patient at the time of entry into the model. Results There were 40 063 patients identified, with a total of 420 773 cycles [remission (197 111; 46.8%), mild–moderate (44 024; 10.5%), moderate–severe (132 695; 31.5%), severe‐fulminant (46 925; 11.2%)]. The costs/QALY for remission, mild–moderate, moderate–severe, and severe–fulminant disease states respectively were $2896, $8428, $11 518 and $69 277 for males and $2896, $8426, $22 633 and $69 412 for females. Conclusions Overall, health care costs for patients with Crohn’s disease increased with disease severity. Although the probabilities of transitioning from other health states to the severe–fulminant disease state were low, the cost/QALY was high.