Patients with Crohn disease (CD) who begin treatment with biologics early after diagnosis have overall reduced health care expenditures compared with patients with CD who initiated biologic treatment later, according to study findings published in Digestive Diseases and Sciences.

Researchers conducted a nationwide, population-based cohort study analyzing the timing of biologic initiation and future health care use among patients with CD. They obtained data from the Merative L.P. MarketScan Database between 2010 and 2016 on patients with CD who began treatment with biologics within 2 years of initial CD diagnosis.

Researchers selected 672 patients with CD who initiated biologic treatment early (≤12 months after diagnosis) and matched them with 672 patients with CD who initiated biologic treatment late (>12-24 months after diagnosis).

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Patients who started taking biologics early had fewer outpatient follow-up visits (15.5 vs 19.8; 95% CI, 2.7-6.1) and decreased total health care costs ($13,646.20 vs $22,180.70; 95% CI, $4748.90-$12,320.10) in the 1 to 2 years following initial diagnosis compared with patients who initiated biologic use later.

Although costs for medication were higher in the early biologic initiator group compared with the later biologic initiator group ($33,766.30 vs $30,580.70; 95% CI, $546.10-$5825.10), overall expenditures when combining medications and other health care costs were lower among the patients who started biologics earlier ($47,412.50 vs $52,761.50; 95% CI, $801.50-$9896.40).

“While biologic treatments are costly and are often not used early in the disease course, our data suggest that patients who initiate biologics sooner after diagnosis have lower HCRU after starting biologics, which potentially leads to overall cost savings over time,” the study authors wrote.

Results for health care use and costs were limited to all-cause and not necessarily CD-related expenses due to lack of available data. The diagnosis of CD and not ulcerative colitis relied on accuracy of claims, proper coding, and accuracy of diagnosis. Additionally, generalizability of estimates did not account for out-of-pocket expenses, disease severity, and omission of unmatched early initiators from the final comparison. Most patients initiated biologic treatment with antitumor necrosis factor (anti-TNF) therapy, potentially limiting interpretation of results to anti-TNF biologics.

Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.


Ungaro RC, Naegeli AN, Choong CKC, et al. Early use of biologics reduces healthcare costs in crohn’s disease: results from a United States population-based cohortDig Dis Sci. Published online March 15, 2023. doi:10.1007/s10620-023-07906-4

This article originally appeared on Gastroenterology Advisor