OBJECTIVES

: The introduction of biologic therapy in the past decade has changed the treatment landscape of Crohn’s disease (CD) in the United States (US). This study aimed to analyze healthcare resource utilization (HCRU) and medication use in the US adult insured population from 2007 to 2017.

METHODS

: Trends in HCRU and medication use were calculated for the 11-year period covering January 1, 2007 to December 31, 2017. Adult (18+ years) CD patients were included in this retrospective analysis of medical and pharmacy claims data from the IBM Marketscan Commercial, Medicaid, and Medicare-Supplemental Claims databases. Patients with an ulcerative colitis diagnosis were excluded. Trends in HCRU and medication use were analyzed in adult patients with a confirmed diagnosis of CD. Subgroups analyses were conducted to compare CD patients prescribed biologics and CD patients not prescribed biologics during each calendar year.

RESULTS

: The prevalence of biologic use among CD patients increased from 12.6% in 2007 to 35.1% in 2017. Corticosteroid use decreased only in biologic users, from 46.6% in 2007 to 39.5% in 2017 (non-biologic (NB) users remained stagnant 32.0% to 32.5%). Surgery decreased in the entire CD population from 3.8% of patients (biologic users 5.8%, NB users 3.5%) in 2007 to 2.8% (biologic users 4.4%, NB 1.9%) in 2017. CD related ER visits increased over for both biologic and non-biologic users from 9.8% to 14.3%, although CD related inpatient hospital stays decreased from 15.1% to 13.1%. CD specific gastroenterologist visits increased for biologic users 71.6% to 78.1%, but decreased for non-biologic users from 50.1% to 48.0%.

CONCLUSIONS

: This study provides real-world evidence on the treatment patterns and HCRU of insured adult CD in the US. From 2007-2017 there was an overall increase in the use of biologic therapy, however biologic users had a decrease in corticosteroid use and surgery prevalence.