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P309. Adherence to 5-aminosalicylic acid therapies in ulcerative colitis: a United Kingdom budget impact analysis

A. Szende1, D. Neves2, J. McDermott2, L. Yen3, 1Covance, Leeds, United Kingdom, 2Covance, Gaithersburg, MD, United States, 3Shire Development LLC, Wayne, PA, United States

Background

Adherence with 5-aminosalicylic acid (5-ASA) treatments has been shown to be associated with a reduction in disease relapses in patients with ulcerative colitis (UC). The aim of this budget impact analysis was to explore and quantify how adherence with individual 5-ASA treatments may impact direct medical costs, through prevented relapses, in the United Kingdom (UK).

Methods

A 1-year decision analytic budget impact model was developed, combining data from a UK-based adherence study of 5-ASA treatments with a chart review study on UC costs by relapse status in the UK. The model calculates rates of disease relapses, remissions, and associated costs, based on adherence rates of each 5-ASA medication. The model also allows users to run simulations of relative changes in treatment utilization to show the associated budget impact from the perspective of the National Health Service (NHS).

Results

Higher adherence rates (48.3% for MMX Multi-Matrix System® [MMX] mesalamine; 40.7% for delayed release mesalamine [DRM] 800 mg; 36.7% for modified release mesalamine [MRM]; 31.8% for controlled release mesalamine [CRM] 1000 mg; 29.7% for controlled release mesalamine [CRM] 500 mg; 29.6% for delayed release mesalamine [DRM] 400 mg; 27.8% for balsalazide) were associated with lower hospitalisation rates (6.6%; 7.3%; 7.7%; 8.1%; 8.3%; 8.3%; and 8.5%, respectively), lower annual hospitalisation costs (£330; £365; £383; £404; £414; £414; and £422, respectively), and lower other medical costs, excluding 5-ASAs (£282; £292; £298; £305; £307; £308; and £310, respectively). The model showed that a hypothetical move from the current utilization mix of 5-ASA treatments to the 5-ASA with the highest adherence rate could save the NHS approximately £92,800 annually per 1,000 UC patients.

Conclusion

As non-adherence in UC is associated with costly medical resource utilization, significant cost-offsets could be achieved within the NHS by favouring the 5-ASA treatment with the highest adherence rate.