Date and Time
March 4, 2009
1:30 PM - 3:00 PM

Availability
Open to the public
No RSVP required

Speaker
Walter Park - Stanford University

Crohn’s disease is a chronic, relapsing inflammatory disorder of the gastrointestinal tract that affects approximately a half million people in the United States.  The cause is presently unknown and there is no cure.  The focus of treatment is to alleviate symptoms and minimize morbidity and mortality. A novel drug class of biologic agents that target tumor necrosis factor alpha (TNF-α) has demonstrated clinical efficacy in the alleviation of symptoms, but at a markedly higher cost than conventional medications. Infliximab, a chimeric murine/human antibody, was the first biologic approved for use in the treatment of Crohn’s disease.  Based on evidence from recent clinical trials, there is an increasing trend to use these infliximab and other biologics earlier in the course of disease.

A cost-effectiveness analysis was performed to determine the relative value of infliximab in several treatment scenarios involving patients newly diagnosed with active Crohn’s disease.  Four strategies are considered. 

• Strategy 1 is the baseline strategy where conventional medications without biologic agents are used. 
  
• Strategy 2 (“Step-Up”) uses infliximab for refractory disease to first and second line drugs.
  
• Strategy 3 (“Early-Aggressive”) uses infliximab immediately after first line drugs, steroids, are unsuccessful. 
  
• Strategy 4 (“Top-Down”) uses infliximab as a first line agent.

Results of this analysis will be presented.