OBJECTIVES: The aim of this literature review was to identify and characterize cost-utility analysis (CUA) published for treatments used in Ulcerative colitis (UC)/ Crohn’s disease (CD) in Europe.

METHODS: Literature searches were carried out in EMBASE^®, and MEDLINE^® databases for articles published between 1^st January 2013 and 12^th April 2023 and the search strategy was limited to Europe. Studies were included based on quality-adjusted life-years (QALYs) as the common measure of effectiveness.

RESULTS: Fifty-two publications were identified for 38 unique CUA (23 UC, 13 CD, and 2 UC/CD studies. Biologics studied were adalimumab, adalimumab biosimilars, golimumab, infliximab, infliximab biosimilars, vedolizumab, and ustekinumab. Other treatments studied were budesonide, mesalazine, methotrexate, and tofacitinib. Among comparators, 13 studies included conventional therapy/standard of care, six studies evaluated surgery and two studies assessed cyclosporine as a comparator. Only one study evaluated the sequencing of biologic therapies. Economic models used were Markov models (n = 26 studies; 17 UC, 7 CD, and 2 UC/CD), a hybrid decision tree-Markov model (n = 8 studies; 4 UC and 4 CD), trial-based models (n = 3 studies; 1 UC and 2 CD) and, a decision tree (UC), while remaining one was un-specified (UC). In six studies (1 UC and 5 CD), a societal perspective was considered. The time horizon of analyses ranged from 1 year to a lifetime). Key health states assessed were remission, mild disease, moderate and/or severe disease, surgery, and death.

CONCLUSIONS: We have identified several CUA model structures for the UC/UD patient population across Europe. With the advent of more treatment options, surgery has transformed from a treatment comparator to a health state. In the future, CUA should assess the impact of the sequencing of biologics, as well as longer time horizons and hybrid decision tree-Markov models.