Leighton JA, Gralnek IM, Richner RE, Lacey MJ, Papatheofanis FJ. Capsule endoscopy in suspected small bowel Crohn’s disease: Economic impact of disease diagnosis and treatment. World J Gastroenterol 2009; 15(45): 5685-5692 [PMID: 19960565 DOI: 10.3748/wjg.15.5685]
Corresponding Author of This Article
Frank J Papatheofanis, MD, MPH, PhD, Division of Health Policy, Department of Radiology, University of California San Diego, 200 W Arbor Drive (MC 9115), San Diego, CA 92103, United States. fpapath@ucsd.edu
Article-Type of This Article
Brief Article
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World J Gastroenterol. Dec 7, 2009; 15(45): 5685-5692 Published online Dec 7, 2009. doi: 10.3748/wjg.15.5685
Capsule endoscopy in suspected small bowel Crohn’s disease: Economic impact of disease diagnosis and treatment
Jonathan A Leighton, Ian M Gralnek, Randel E Richner, Michael J Lacey, Frank J Papatheofanis
Jonathan A Leighton, Division of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, AZ 85259, United States
Ian M Gralnek, Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, GI Outcomes Unit, Departments of Gastroenterology and Ambulatory Care Services, Rambam Health Care Campus, Haifa 31096, Israel
Randel E Richner, Michael J Lacey, The Neocure Group, Sherborn, MA 01770, United States
Frank J Papatheofanis, Division of Health Policy, Departments of Radiology and Economics, University of California San Diego, San Diego, CA 92103, United States
Author contributions: Leighton JA and Gralnek IM provided clinical information concerning the study design; Papatheofanis FJ designed and completed the economic analysis with input from all co-authors; all co-authors participated in writing the manuscript.
Supported by (in part) A Research Grant from Given Imaging, Ltd., Duluth, GA 30096, United States
Correspondence to: Frank J Papatheofanis, MD, MPH, PhD, Division of Health Policy, Department of Radiology, University of California San Diego, 200 W Arbor Drive (MC 9115), San Diego, CA 92103, United States. fpapath@ucsd.edu
Telephone: +1-508-6556161 Fax: +1-508-6556167
Received: September 18, 2009 Revised: October 21, 2009 Accepted: October 28, 2009 Published online: December 7, 2009
Abstract
AIM: To model clinical and economic benefits of capsule endoscopy (CE) compared to ileo-colonoscopy and small bowel follow-through (SBFT) for evaluation of suspected Crohn’s disease (CD).
METHODS: Using decision analytic modeling, total and yearly costs of diagnostic work-up for suspected CD were calculated, including procedure-related adverse events, hospitalizations, office visits, and medications. The model compared CE to SBFT following ileo-colonoscopy and secondarily compared CE to SBFT for initial evaluation.
RESULTS: Aggregate charges for newly diagnosed, medically managed patients are approximately $8295. Patients requiring aggressive medical management costs are $29 508; requiring hospitalization, $49 074. At sensitivity > 98.7% and specificity of > 86.4%, CE is less costly than SBFT.
CONCLUSION: Costs of CE for diagnostic evaluation of suspected CD is comparable to SBFT and may be used immediately following ileo-colonoscopy.
