Cost-Consequences Analysis of Biologic Treatments for Moderate-to-Severe Crohn’s Disease Using Real-World Transition Probability and Cost Data in Thailand
Issued Date
2026-01-01
Resource Type
ISSN
11732563
eISSN
11791918
Scopus ID
2-s2.0-105030191242
Pubmed ID
41686359
Journal Title
Clinical Drug Investigation
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SCOPUS
Bibliographic Citation
Clinical Drug Investigation (2026)
Suggested Citation
Chaemsupaphan T., Sattayalertyanyong O., Kongpakwattana K., Subdee N., Chuenprapai P., Limsrivilai J. Cost-Consequences Analysis of Biologic Treatments for Moderate-to-Severe Crohn’s Disease Using Real-World Transition Probability and Cost Data in Thailand. Clinical Drug Investigation (2026). doi:10.1007/s40261-026-01526-2 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/115289
Title
Cost-Consequences Analysis of Biologic Treatments for Moderate-to-Severe Crohn’s Disease Using Real-World Transition Probability and Cost Data in Thailand
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Abstract
Background and Objectives: The treatment goal for patients with Crohn’s disease (CD) is sustained clinical, biochemical, and endoscopic remission, with biologic therapy often necessary in moderate-to-severe cases. This study aimed to evaluate the value of biologic agents in moderate-to-severe CD in Thailand by assessing cost consequences using real-world transition probabilities and cost data. Methods: A published decision tree combined with a Markov model was adapted to estimate 2-year health outcomes, healthcare resource utilization, and cost implications of treatment options (conventional therapy, overall biologic therapies, infliximab, vedolizumab, and ustekinumab) for moderate-to-severe CD. The base-case analysis used a 2-year time horizon. Key input parameters, including transition probabilities and costs, were obtained from real-world data at Siriraj Hospital, a tertiary hospital in Thailand, while efficacy and safety data were sourced from relevant published literature. Uncertainty was assessed through scenario analyses and one-way sensitivity analyses varying input parameters across plausible ranges. Results: Overall, biologics demonstrated superior health outcomes compared to conventional therapy, with a higher remission rate (number needed to treat = 4) and reduced healthcare resource utilization, including lower hospitalization (absolute risk reduction; ARR = 135.3%) and fewer CD-related surgeries (ARR = 40.5%), although with a higher incidence of adverse drug reactions. Among biologic-naïve patients, infliximab was the most effective agent, with a cost-saving of 171,213 Thai baht compared to conventional therapy. Scenario and sensitivity analyses revealed consistent findings, with infliximab consistently dominating in biologic-naïve patients. Cost-effectiveness analyses demonstrated that infliximab dominated conventional therapy among biologic-naïve patients, while conventional therapy remained most cost-effective in biologic-exposed patients. Conclusions: Biologic therapy improved outcomes and reduced healthcare use compared with conventional therapy, but cost considerations remain crucial. Infliximab was most effective and cost-saving in biologic-naïve patients, whereas conventional therapy remained most cost effective in biologic-exposed patients. These real-world findings support treatment decisions for moderate-to-severe CD in Thailand.