ECONOMIC IMPACT OF CDST USE IN CROHN'S DISEASE: A FRENCH BUDGET IMPACT MODEL
Author(s)
José Fernandes Soares, MSc1, Juliette Placer, MSc2, Cinira Lefevre, PhD3, Laure Abily, PhD4, Mathurin FLAMANT, MD, PhD5, Aurélien Amiot, MD, PhD6, Anthony Buisson, MD, PhD7, Gérard de Pouvourville, PhD8, Nicolas MATHIEU, MD9.
1Rweality, Paris, France, 2Universite Paris-Saclay, Ermont, France, 3Data Value Generation & Health Economics Lead, TAKEDA, Courbevoie, France, 4Medical Affairs, Takeda, Courbevoie, France, 5Clinique Jules Verne, Nantes, France, 6Hopitaux Universitaires Bicêtre, AP-HP, Université Paris Saclay, Le Kremlin-Bicêtre, France, 7CHU Clermont Ferrand, Clermont Ferrand, France, 8ESSEC, Paris, France, 9MICI Institut Privé, Clinique des Cèdres, Échirolles, France.
1Rweality, Paris, France, 2Universite Paris-Saclay, Ermont, France, 3Data Value Generation & Health Economics Lead, TAKEDA, Courbevoie, France, 4Medical Affairs, Takeda, Courbevoie, France, 5Clinique Jules Verne, Nantes, France, 6Hopitaux Universitaires Bicêtre, AP-HP, Université Paris Saclay, Le Kremlin-Bicêtre, France, 7CHU Clermont Ferrand, Clermont Ferrand, France, 8ESSEC, Paris, France, 9MICI Institut Privé, Clinique des Cèdres, Échirolles, France.
OBJECTIVES: Crohn’s disease is associated with high healthcare costs, particularly related to advanced therapies and surgical management, highlighting the need to optimize treatment allocation in clinical practice. This study aimed to assess the economic consequences of integrating a validated predictive score of treatment response, the Crohn’s disease Clinical Decision Support Tool (CDST) into the treatment pathway of patients eligible for vedolizumab in France.
METHODS: A budget impact model based on a Markov state-transition framework was developed from a French National Health Insurance perspective. The model compared two scenarios: current practice without CDST, where all eligible patients receive vedolizumab, and a CDST-based strategy in which only patients with a score ≥19 (high probability of response) receive vedolizumab while others receive alternative therapies. Model inputs (clinical outcomes, treatment pathways, and resource use) were derived from published literature and supplemented with clinical expert opinion to reflect real-world practice. The analysis included incident annual cohorts of 1,000 patients over a 5-year horizon for each scenario, with treatment sequences modelled across up to five lines and 3-month cycles using health states and transition probabilities. Costs considered included drug acquisition, administration, surgery (including hospitalization days) and CDST testing, which comprises an albumin test and C-reactive protein test.
RESULTS: The model showed that the CDST strategy generated cost savings from the first year onward. Over 5-years, cumulative savings reached €2,782,666, approximately €186 per patient per year. The cost difference between the two scenarios is driven by savings generated in the CDST scenario, mainly related to delayed recourse to surgery and improved treatment allocation (by reducing costs related to less effective treatments). Sensitivity analyses varying models’ hypotheses confirmed the robustness of the results.
CONCLUSIONS: These findings suggest that integrating CDST into clinical practice may improve the efficiency of healthcare resource utilization and generate sustainable cost savings at the payer level.
METHODS: A budget impact model based on a Markov state-transition framework was developed from a French National Health Insurance perspective. The model compared two scenarios: current practice without CDST, where all eligible patients receive vedolizumab, and a CDST-based strategy in which only patients with a score ≥19 (high probability of response) receive vedolizumab while others receive alternative therapies. Model inputs (clinical outcomes, treatment pathways, and resource use) were derived from published literature and supplemented with clinical expert opinion to reflect real-world practice. The analysis included incident annual cohorts of 1,000 patients over a 5-year horizon for each scenario, with treatment sequences modelled across up to five lines and 3-month cycles using health states and transition probabilities. Costs considered included drug acquisition, administration, surgery (including hospitalization days) and CDST testing, which comprises an albumin test and C-reactive protein test.
RESULTS: The model showed that the CDST strategy generated cost savings from the first year onward. Over 5-years, cumulative savings reached €2,782,666, approximately €186 per patient per year. The cost difference between the two scenarios is driven by savings generated in the CDST scenario, mainly related to delayed recourse to surgery and improved treatment allocation (by reducing costs related to less effective treatments). Sensitivity analyses varying models’ hypotheses confirmed the robustness of the results.
CONCLUSIONS: These findings suggest that integrating CDST into clinical practice may improve the efficiency of healthcare resource utilization and generate sustainable cost savings at the payer level.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE640
Topic
Economic Evaluation, Organizational Practices
Topic Subcategory
Budget Impact Analysis
Disease
Gastrointestinal Disorders