Advances in the management of Crohn's disease: economic and clinical potential of infliximab.

New therapies for Crohn's disease are being developed based on improvements in our understanding of the disease's immune and inflammatory properties. One of these new therapies is infliximab, a monoclonal antibody directed against the proinflammatory cytokine tumor necrosis factor-alpha. Recent studies indicate that treatment of moderately to severely ill Crohn's disease patients with infliximab produces a rapid and profound reduction in the signs, symptoms, and severity of this disease. Beyond its clinical impact, Crohn's disease also carries significant economic consequences. Earlier reports on the costs of managing this disease estimated the average annual medical costs per patient at $9197, with the total annual cost of illness estimated to exceed $1.7 billion. Hospitalizations and surgeries represented 80% of these costs. Additional analyses have been conducted for this review to reflect more current treatment patterns. Assuming that proven increases in response and remission rates lead to diminished disease severity, infliximab can be expected to reduce the number of hospitalizations and surgeries in moderately to severely ill patients, with substantial cost savings. Moreover, improvement in disease status and quality of life may allow Crohn's disease patients to lead more productive lives.