Health outcomes and cost–effectiveness of certolizumab pegol in the treatment of Crohn’s disease

Abstract

Crohn’s disease (CD) causes chronic inflammation of the gastrointestinal tract and leads to fluctuations between active disease and remission. Certolizumab pegol is one of the newer biological treatments for patients with moderate-to-severe CD. Certolizumab pegol was shown to be effective in CD patients achieving response and remission in both randomized and non-randomized studies, and is an alternative biological treatment for CD. The available data show that certolizumab pegol achieves similar therapeutic efficacy and health-related quality of life scores in CD patients as the other biological agents, but at a higher cost, if dose escalation of other biologics is not considered. Considering subcutaneous self-administration, and lower number and frequency of injections, patients may prefer certolizumab pegol over the other biological treatments.

Keywords::

• biologics
• certolizumab pegol
• Crohn’s disease
• inflammatory bowel disease

Acknowledgement

The authors would like to thank J Martin from Information Services at the Arizona Health Sciences Library for assisting with the literature searches and obtaining abstracts for this review.

Financial & competing interests disclosure

EP Armstrong is a consultant to UBC Inc. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Crohn’s disease (CD) is an important disease for patients, caregivers and health systems due to its important clinical, economic and health-related quality of life consequences.

• Biological therapies have been shown to significantly improve the health-related quality of life in patients with CD.

• Certolizumab pegol appears to have comparable clinical efficacy as the other biological treatments used to manage CD.

• Dose escalation over time can raise the cost of biological products (e.g., infliximab) and this feature worsens their cost–effectiveness.

• When biological therapies are administered in outpatient healthcare facilities, subcutaneous injections are less costly than intravenous infusions.

• Certolizumab pegol and adalimumab administration have the advantage that they can be delivered by subcutaneous injections that some patients may successfully administer at home.

• Administration costs are important variables in determining the cost–effectiveness of biological therapies.

• Long-term research is needed to better quantify biological therapy outcomes and cost–effectiveness for CD patients.