OBJECTIVES: This study aimed to evaluate the economic burden of vedolizumab, infliximab and its biosimilars, adalimumab and its biosimilars, and ustekinumab for Crohn’s disease (CD) patients from Chinese societal perspective.

METHODS: This study compared the economic burden of various treatments by calculating the average annual costs. The economic burden of patients included direct medical costs (drug acquisition, administration, adverse event, disease management, surgery, surgical complication management), direct non-medical costs (i.e., transportation), and indirect costs (productivity loss). The prices of proprietary biologics (i.e., branded vedolizumab, infliximab, adalimumab, and ustekinumab) were obtained from the Yaozhi database, while the biosimilars prices of infliximab and adalimumab were the average price of those biosimilar drugs. Costs of administration, adverse event, disease management, surgery, surgical complication management were obtained from published literatures. The transportation cost for a single patient visit was assumed to be 60 RMB, and the average work loss per visit was 0.5 days. The average daily wage of employed population, the proportion of labor force population to total population, and the employment rate obtained from China Statistical Yearbook (2022) were used to calculate the productivity loss of different treatments.

RESULTS: The economic burden of various treatment options ranked from high to low is as follows: infliximab (103,126 RMB), adalimumab (98,053 RMB), adalimumab biosimilar (89,709 RMB), infliximab biosimilar (87,144 RMB), ustekinumab (79,396 RMB), and vedolizumab (78,072 RMB). Due to the high drug acquisition costs of infliximab, it has the highest economic burden. Adalimumab has the highest number of annual visits, resulting in higher administration costs, transportation costs, and productivity loss. Ustekinumab and vedolizumab have similar drug costs and resource utilization, resulting in comparable economic burden.

CONCLUSIONS: Vedolizumab and ustekinumab are more economically feasible treatments. These findings can inform clinical practice and hospital listing, ultimately improving the quality of care for CD patients in China.