Satwik Motaganahalli1, Lauren Beswick1, Danny Con1, Daniel R van Langenberg1,2. 1. Department of Gastroenterology, Eastern Health, Monash University, Melbourne, Victoria, Australia. 2. Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia.
Abstract
BACKGROUND: Faecal calprotectin (FC) is an accurate biomarker of disease activity in inflammatory bowel disease (IBD), yet the cost/resource implications of incorporating FC into 'real-world' practice remain uncertain. AIM: To evaluate the utility of FC in clinical decision-making and on healthcare costs in IBD. METHODS: Retrospective data, including colonoscopy/other investigations, medication, admission and surgical data, were collected from hospital records and compared between two groups: pre-FC historical cohort (2005-2009) where colonoscopy was used to assess IBD activity versus the cohort where FC was used first instead (2010-2014). Post-test costs were also compared. RESULTS: A total of 357 FC tests (246 patients, 2010-2014) and 450 colonoscopies (268 patients, 2005-2009) were performed. On subsequent review, both FC and colonoscopy (in their respective cohorts) were associated with changes in management in 50.7 versus 56.2% (P = 0.14), respectively, with similar proportions of subsequent IBD-related investigations within 6 months (21.8 vs 21.9%, P = 1.0). Prior to FC availability (2005-2009), a colonoscopy for disease reassessment cost AU$606 578 (cost per patient-year $1887.34) versus AU$282 048 (cost per patient-year $968.60) when FC ± colonoscopy was used (2010-2014). Within the FC cohort, 73.6% did not proceed to colonoscopy within 6 months post-FC, and 60.6% had not undergone colonoscopy post-FC by the end of follow up (median 1.8 years (0.1, 4.6) post-FC). Those with FC ≥ 250 were scoped earlier than those with FC < 100 μg/mL (median 0.49 vs 1.0 years, P = 0.03). CONCLUSION: Introduction of FC into routine IBD care aided changes in clinical management in a similar proportion, yet at potentially half the total cost, compared to a historical colonoscopy-only cohort at the same centre.
BACKGROUND: Faecal calprotectin (FC) is an accurate biomarker of disease activity in inflammatory bowel disease (IBD), yet the cost/resource implications of incorporating FC into 'real-world' practice remain uncertain. AIM: To evaluate the utility of FC in clinical decision-making and on healthcare costs in IBD. METHODS: Retrospective data, including colonoscopy/other investigations, medication, admission and surgical data, were collected from hospital records and compared between two groups: pre-FC historical cohort (2005-2009) where colonoscopy was used to assess IBD activity versus the cohort where FC was used first instead (2010-2014). Post-test costs were also compared. RESULTS: A total of 357 FC tests (246 patients, 2010-2014) and 450 colonoscopies (268 patients, 2005-2009) were performed. On subsequent review, both FC and colonoscopy (in their respective cohorts) were associated with changes in management in 50.7 versus 56.2% (P = 0.14), respectively, with similar proportions of subsequent IBD-related investigations within 6 months (21.8 vs 21.9%, P = 1.0). Prior to FC availability (2005-2009), a colonoscopy for disease reassessment cost AU$606 578 (cost per patient-year $1887.34) versus AU$282 048 (cost per patient-year $968.60) when FC ± colonoscopy was used (2010-2014). Within the FC cohort, 73.6% did not proceed to colonoscopy within 6 months post-FC, and 60.6% had not undergone colonoscopy post-FC by the end of follow up (median 1.8 years (0.1, 4.6) post-FC). Those with FC ≥ 250 were scoped earlier than those with FC < 100 μg/mL (median 0.49 vs 1.0 years, P = 0.03). CONCLUSION: Introduction of FC into routine IBD care aided changes in clinical management in a similar proportion, yet at potentially half the total cost, compared to a historical colonoscopy-only cohort at the same centre.
Authors: Ferdinando D'Amico; David T Rubin; Paulo Gustavo Kotze; Fernando Magro; Britta Siegmund; Taku Kobayashi; Pablo A Olivera; Peter Bossuyt; Lieven Pouillon; Edouard Louis; Eugeni Domènech; Subrata Ghosh; Silvio Danese; Laurent Peyrin-Biroulet Journal: United European Gastroenterol J Date: 2021-05-07 Impact factor: 4.623
Authors: Brenda Maldonado-Arriaga; Sergio Sandoval-Jiménez; Juan Rodríguez-Silverio; Sofía Lizeth Alcaráz-Estrada; Tomás Cortés-Espinosa; Rebeca Pérez-Cabeza de Vaca; Jonathan Shaw; Paul Mondragón-Terán; Cecilia Hernández-Cortez; Juan Antonio Suárez-Cuenca; Graciela Castro-Escarpulli Journal: F1000Res Date: 2020-12-21