Dr. Daniel Erim, doctoral student in the Department of Health Policy and Management at the University of North Carolina Gillings School of Global Public Health, recently co-authored two papers sharing new research on Crohn’s disease. Crohn’s is an inflammatory bowel disease that can cause abdominal pain, fatigue and malnutrition, among other symptoms.
[Photo: Dr. Daniel Erim]
The first article is titled “The Value of Vedolizumab as Rescue Therapy in Moderate-Severe Crohn’s Disease Patients with Adalimumab Non-response in the USA,” and was published online May 18 by the Journal of Crohn’s and Colitis.
Dr. Erim and co-authors found that the drug vedolizumab can, in the short term, significantly improve the quality of life of patients with Crohn’s disease who do not respond to the drug adalimumab.
Using a Markov model to simulate a virtual cohort of Crohn’s disease patients, the research team found that within a 12-month period, treatment with vedolizumab reduced the average total cost per patient by 10 percent and increased the average amount of time spent in remission or with a mild form of the disease by up to two months.
They also determined that the cost of this medication might preclude access to it in the United States. The National Institute for Health and Care Excellence made a similar determination in the United Kingdom.
Dr. Stephanie Wheeler, assistant professor of health policy and management at UNC, was senior author of the study.
“This research has important health and economic implications for Crohn’s disease patients living with what can be a very debilitating and expensive condition,” Dr. Wheeler said. “This article demonstrates the usefulness of cost-effectiveness analyses in informing decision makers and patients about the value of therapeutic alternatives for chronic conditions like Crohn’s.”
Dr. Erim’s second article, “Cost-effectiveness of Prophylaxis Against Pneumocystis jiroveci Pneumonia in Patients with Crohn’s Disease,” was published online July 16 by Digestive Diseases and Sciences.
As co-author, Dr. Erim again used simulation modeling to address the debate over the need for chemoprophylaxis to combat Pneumocystis jiroveci pneumonia (PJP) in Crohn’s disease patients on corticosteroids.
Results showed that avoiding PJP chemoprophylaxis was the preferred strategy from a general population perspective. However, as the risk of pneumonia increased in specific patients, chemoprophylaxis became the preferred treatment. Ultimately, the findings support a case-by-case consideration of chemoprophylaxis in patients with Crohn’s.
“While we’re grateful for the opportunity to contribute to conversations on care for Crohn’s disease patients,” Dr. Erim said, “we’re also mindful of what we still don’t know about the disease, and we wish to encourage additional research.”