Introduction
diarrhoea, ®, ulcerative colitis, abdominal pain, ASUC, UC, Ulcerative colitis
MUCOSAL ULCERATION, ULCERATIVE COLITIS, RECTAL BLEEDING, CHRONIC INFLAMMATORY DISORDER, ULCERATIVE COLITIS
Ulcerative colitis (UC) is a chronic inflammatory disorder of the colon, characterised by mucosal ulceration, rectal bleeding, diarrhoea and abdominal pain [A number of previous studies have confirmed the efficacy of infliximab and ciclosporion in the treatment of patients with moderate or severe steroid-resistant UC [A European randomised controlled trial (CYSIF) found no statistically significant difference between infliximab and ciclosporin in clinical effectiveness at 12 months but the study did not report on cost-effectiveness of the treatments [CONSTRUCT was an open-label, multicentre, parallel-group, pragmatic randomised clinical trial (RCT) with 3-years follow up (FU). A total of 270 adults admitted with acute severe ulcerative colitis who failed to respond to 2–5 days intravenous hydrocortisone were recruited from 52 district general and teaching hospitals across England, Scotland and Wales [At the time of the CONSTRUCT trial infliximab was still on patent as Remicade®. When the patent expired in 2015 biosimilars such as Inflectra® and Remsima® were launched in the UK with an NHS list price of £377.66 per 100 mg vial, which is 10% lower than the list price of Remicade® (£419.62 per 100 mg vial) [In this study, we have developed and validated decision analytical models that allowed extrapolation of health effect and resource use implications of competing treatments beyond trial follow up period and estimation of long-term cost-effectiveness of infliximab versus ciclosporin for steroid resistant ASUC patients.