S0464 Cost Reduction Associated With Improvement in Work Productivity Loss From Ustekinumab Treatment by Disease Severity States in Crohn's Disease Patients: Results From the IM-UNITI Clinical Trial
Bibliographic record
Abstract
INTRODUCTION: The economic burden associated with work productivity loss (WPL) is substantial in patients with Crohn’s Disease (CD). The objective of this study was to model the indirect costs associated with WPL for patients with CD treated with ustekinumab (UST) using US dollars. METHODS: The average percentage of work time missed (absenteeism) and impairment in productivity while at work (presenteeism) due to CD were calculated using Work Productivity and Activity Impairment (WPAI) scores from a prior study of the Adelphi Disease Specific Programme (1). Patient-level data from the IM-UNITI trial was used to classify patients into disease severity states at week 44 in maintenance based on the Crohn’s Disease Activity Index (CDAI): remission (rem) (0–150), mild (151–220) and moderate to severe (mod/sev) (>220). The total costs associated with WPL (absenteeism + presenteeism) were estimated for each state using WPL data from the Adelphi study and an annual salary of $54,906 reported by the Bureau of Labor Statistics and the Census Bureau in 2018. RESULTS: Of the 248 patients treated with UST 6 mg/kg at induction and 90 mg every 8 or 12 weeks at maintenance (UST 6-UST 90 Q8W/Q12W), 53%, 16%, and 31% were in rem, mild and mod/sev states at week 44 of maintenance, respectively. Similarly, 54%, 16%, and 29% of patients treated with UST 6-UST 90 Q8W (n = 178) and 15%, 15%, and 69% of the patients in the placebo induction arm (n = 399) were in rem, mild and mod/sev states, respectively. The average costs of absenteeism and presenteeism per state were estimated as $527 and $6,307 for remission, $2,462 and $14,773 for mild, and $8,001 and $19,989 for mod/sev states, respectively. A patient remaining in the mod/sev state had an annual WPL associated cost of $27,990. Figure 1 reports the average costs for a CD patient among arms. Relative to remaining in a mod/sev state, the annual cost associated with reductions in WPL were estimated as $12,912, $13,238, and $4,901 for UST 6-UST 90 Q8W/Q12W, UST6-UST 90 Q8W and placebo, respectively. Treatment with UST 6-UST90 Q8W over a year is estimated to save $8,337 per patient compared to placebo. CONCLUSION: Costs associated with WPL were lower for patients treated with UST than for placebo patients. The considerable cost reduction in WPL estimated for UST was threefold higher versus placebo.(1) Obando et al. Work productivity loss and associated indirect costs for patients with Crohn's disease in the US. AMCP Nexus 2019; Abstract K5.Figure 1.: Average annual WPL costs per-patient per arm and for a patient remaining in a moderate to severe state.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.007 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".