Cost-Effectiveness in Reducing Postoperative Recurrence of Crohn Disease

Postoperative recurrence of Crohn disease is common, and a recent trend based on strongly positive results of small studies is the use of anti–tumor necrosis agents in high-risk patients. Now, researchers have conducted a cost-effectiveness analysis of five medication strategies for preventing postoperative recurrence within 1 year: antibiotics, azathioprine, infliximab, “tailored” infliximab (no treatment for 6 months followed by infliximab for patients with severe endoscopic recurrence at 6 months), and no treatment. Investigators considered US$80,000 per quality-adjusted life-year (QALY) gained as the threshold for cost-effectiveness.

In the base-case analysis, up-front infliximab was the most effective strategy at 1 year, followed by ant…