OBJECTIVES: Work-productivity loss (WPL) is an important contributor to the economic burden of Crohn’s disease (CD). Ustekinumab (UST) is a biologic for treating adults with moderate-to-severe CD. We aimed to report WPL and associated costs in patients with CD receiving UST, relative to those with moderate-to-severe CD not receiving UST, in the real world.

METHODS: Data were collected using the Adelphi Inflammatory Bowel Disease-Disease Specific Programme™, a point in time study of gastroenterologists and their CD patients in the United States from 3 waves; 2015 and 2017 which captured moderate-to-severe patients (defined by Crohn’s Disease Activity Index >220) not receiving UST and then 2021 which captured CD patients receiving UST. Gastroenterologists completed patient record forms for their next 5 – 10 consulting CD patients. Patients completed a voluntary self-completion form including the Work Productivity Activity Impairment (WPAI) questionnaire. All UST patients were receiving UST at time of consultation. A mean annual wage of $57,900 USD was used to calculate WPL (U.S. Census Bureau 2019).

RESULTS: 197 CD patients receiving UST and 72 moderate-to-severe CD patients receiving other therapies at last consultation were included. Mean age was 42.9 and 39.1 with mean disease duration of 4.0 and 5.5 years for the UST and moderate-to-severe groups, respectively. For patients with data for all WPAI domains, mean overall work impairment at last consultation was 21.1% in UST (n=39) and 51.0% for moderate-to-severe patients (n=39). At last consultation, UST and moderate-to-severe patients had mean presenteeism of 19.8% and 44.9%, and mean absenteeism of 3.2% and 16.7%, respectively. Associated mean annual total WPL costs per patient were $12,211 for UST patients and $30,096 for moderate-to-severe CD patients.

CONCLUSIONS: Real-world effectiveness of UST in CD patients was evident from reduced absenteeism, presenteeism and costs associated with WPL following UST initiation.