Mayen-Herrera E1, Pozos JC2, Yang M3, Cortina D4. OBJECTIVES: To estimate the cost-effectiveness of adalimumab CD treatment versus standard care and infliximab for patients with severe active CD. METHODS: The model combines clinical, utility, and cost data. Four disease states (remission; moderate; severe; very severe) based on the Crohn’s Disease Activity Index range are used as measures of patient disease status. For the adalimumab arm, a cohort for the proposed adalimumab regimen using actual observations from the EOW arm in a randomized controlled clinical trial (CHARM) is used.  For the standard care arm, the model simulates patient disease states based on randomized controlled trial data (CLASSIC I and CHARM) and calculates the probability of individuals being in each disease state. The base-case model analyzes lifetime patient clinical status. Hospitalization costs are estimated from the hospitalization unit cost and a regression model based on CHARM trial data.  Disease state specific non-hospitalization, non-anti TNF costs are summarized over time for each patient to include other direct medical costs.  For the adalimumab vs. infliximab model, the adalimumab regimen is compared to infliximab 5mg/kg maintenance therapy.  The percentage of patients in remission over time is used as the measure of clinical efficacy. Indirect costs are estimated based on hospitalization stays and post-hospitalization recovery times. Costs are reported in Mexican Peso. RESULTS: Compared to standard care, adalimumab is dominant for patients with severe CD (cost difference -$16,825, gain in QALYs 0.1045). Adalimumab is dominant, with lower costs and higher efficacy compared with infliximab when treating patients with severe disease based on a societal perspective. Cost difference (adalimumab–infliximab) were -$19,784, and including infliximab “overdosing”, the costs accounted for  -$42,356. Sensitivity analyses confirm the results obtained in the cost-effectiveness analysis. CONCLUSIONS: Adalimumab maintenance therapy is dominant over standard care. The adalimumab regimen is cost-saving over infliximab 5mg/kg maintenance therapy.