OBJECTIVES: Perianal fistulae are a common complication of Crohn´s Disease (CD) and impose a substantial quality of life burden; however, data capturing health-related utility associated with perianal fistulae in CD are scarce. The aim of this study is to conduct a systematic literature review to identify published studies reporting health-related utility values in patients with fistulae and/or CD.

METHODS: A comprehensive search strategy was developed and refined to identify papers reporting empirical utility data in patients with fistulae and/or CD or undergoing surgical procedures similar to those carried out in patients with perianal fistulae and CD. The base search was conducted in Embase and Medline. This was followed by a search of relevant economic models reported in Tufts CEA Registry database, EuroQol database, ScHARRHUD, NHS EED, HTA Database and NICE website. Quality assessment was conducted for each included study.

RESULTS: In summary, 37 unique published studies were included. Six of the 37 included studies were assessed as good quality. Only one paper reported data for fistula-related health states. This reported utilities for fistula, improved fistula and perianal abscess with CD, but the methods of elicitation were unclear. The perianal fistula status was unknown in the remaining studies reporting CD health states. They reported a range of utility values based on severity condition, from 0.87 for remission state to 0.22 to severe CD. None of the articles reported self-reported data from patients with perianal fistula. A total of seventeen studies reported utility data for surgical health states in patients not defined as having CD.

CONCLUSIONS: There is a lack of studies reporting health-related utility associated with fistula and perianal fistula in CD. There is a reasonably sized literature on health-related utility for patients with CD and associated surgery, however much of this is poor or fair quality.