Evaluation of economic burden with biologic treatments in Crohn’s disease patients: A mirror image study using an insurance database in Japan
Biologics are recommended in Japan to treat moderate to severe Crohn’s Disease (CD). Although CD is associated with high direct costs in Japan, updated information after ustekinumab’s approval is unavailable. We aimed to evaluate the healthcare resource utilization (HRU) and associated direct costs...
Gespeichert in:
| Veröffentlicht in: | PloS one 2021-07, Vol.16 (7), p.e0254807-e0254807 |
|---|---|
| Hauptverfasser: | , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | e0254807 |
|---|---|
| container_issue | 7 |
| container_start_page | e0254807 |
| container_title | PloS one |
| container_volume | 16 |
| creator | Miyazaki, Celine Katsumasa, Nagano Huang, Kuan Chih Liu, Yan Fang |
| description | Biologics are recommended in Japan to treat moderate to severe Crohn’s Disease (CD). Although CD is associated with high direct costs in Japan, updated information after ustekinumab’s approval is unavailable. We aimed to evaluate the healthcare resource utilization (HRU) and associated direct costs from the payer’s perspective in Japan. Claims data (2010–2018) were retrospectively analyzed to identify patients with CD. HRU and associated costs were evaluated for 12 months before and after biologic initiation and followed-up till 36 months post-initiation. Outcomes were reported using descriptive statistics. Among the included patients (n = 3,496), 1,783 were on biologics and 1,713 were on non-biologics. Mean (SD) age was 36.4 (13.2) years and patients were predominantly male (76.1%). Patients aged 18–39 years were affected with CD the most (55.3%). Biologic initiation was associated with a reduction in inpatient stay, length of stay, outpatient visits, and associated costs; and an increase in pharmacy costs and total costs after 12 months. Extended follow-up showed a decreasing trend in HRU and costs till 24 months but an increase after 36 months. These findings demonstrated reduction in clinical burden and slight increase in economic burden with biologics. However, indirect costs also need to be evaluated. |
| doi_str_mv | 10.1371/journal.pone.0254807 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_plos_</sourceid><recordid>TN_cdi_plos_journals_2553219070</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A669020682</galeid><doaj_id>oai_doaj_org_article_eed567d2c6054272be60fc9f1dab3d8e</doaj_id><sourcerecordid>A669020682</sourcerecordid><originalsourceid>FETCH-LOGICAL-c669t-aae045b8f2d34c8d1911ea00c00ec1b817bc96922382d533cd3319b3d238b5203</originalsourceid><addsrcrecordid>eNqNk81u1DAQxyMEoqXwBkhYQkJw2MUfSTbhgLRaFVhUqRJfV2tiT7KusvZiO4XeeAPOvB5PgsMuqEE9oBwcjX_zH89fM1n2kNE5Ewv2_MIN3kI_3zmLc8qLvKKLW9kxqwWflZyK29f-j7J7IVxQWoiqLO9mRyLnFeU5P86-n15CP0A0zhLXElTOuq1RpBm8Rku-mLghjXG961IweoS4RRsDMZasvNvYn99-BKJNQAhIdklnvH1BlmRrvHeemC10SEIc9BUZgrEdAZuSw-DBKiQaIjRjatJ7Czuw97M7LfQBHxzOk-zjq9MPqzezs_PX69XybKbKso4zAKR50VQt1yJXlWY1YwiUKkpRsaZii0bVZc25qLguhFBaCFY3QqdAUyRHTrJHe91d74I8eBkkLwrBWU0XI7HeE9rBhdz51Im_kg6M_B1wvpPgo1E9SkRdlAvNVUmLnC94gyVtVd0yDalkhUnr5aHa0GxRq2SSh34iOr2xZiM7dykrXtVUFEng6UHAu88Dhii3Jijse7Dohv27Cy5EPr778T_ozd0dqA5SA8a2LtVVo6hcJocpp2XFEzW_gUqfxjQkafBak-KThGeThMRE_Bo7GEKQ6_fv_p89_zRln1xjNwh93ATXD-PchimY70HlXQge278mMyrHvfnjhhz3Rh72RvwC55MLbQ</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2553219070</pqid></control><display><type>article</type><title>Evaluation of economic burden with biologic treatments in Crohn’s disease patients: A mirror image study using an insurance database in Japan</title><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><source>Free Full-Text Journals in Chemistry</source><source>Public Library of Science (PLoS)</source><creator>Miyazaki, Celine ; Katsumasa, Nagano ; Huang, Kuan Chih ; Liu, Yan Fang</creator><creatorcontrib>Miyazaki, Celine ; Katsumasa, Nagano ; Huang, Kuan Chih ; Liu, Yan Fang</creatorcontrib><description>Biologics are recommended in Japan to treat moderate to severe Crohn’s Disease (CD). Although CD is associated with high direct costs in Japan, updated information after ustekinumab’s approval is unavailable. We aimed to evaluate the healthcare resource utilization (HRU) and associated direct costs from the payer’s perspective in Japan. Claims data (2010–2018) were retrospectively analyzed to identify patients with CD. HRU and associated costs were evaluated for 12 months before and after biologic initiation and followed-up till 36 months post-initiation. Outcomes were reported using descriptive statistics. Among the included patients (n = 3,496), 1,783 were on biologics and 1,713 were on non-biologics. Mean (SD) age was 36.4 (13.2) years and patients were predominantly male (76.1%). Patients aged 18–39 years were affected with CD the most (55.3%). Biologic initiation was associated with a reduction in inpatient stay, length of stay, outpatient visits, and associated costs; and an increase in pharmacy costs and total costs after 12 months. Extended follow-up showed a decreasing trend in HRU and costs till 24 months but an increase after 36 months. These findings demonstrated reduction in clinical burden and slight increase in economic burden with biologics. However, indirect costs also need to be evaluated.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0254807</identifier><identifier>PMID: 34280242</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Adults ; Biological products ; Biological treatment ; Biology and Life Sciences ; Care and treatment ; Comorbidity ; Cost analysis ; Cost estimates ; Costs ; Crohn's disease ; Disease ; Economics ; Employees ; Enteral nutrition ; Epidemiology ; Evaluation ; Health economics ; Insurance coverage ; Medical care ; Medical care, Cost of ; Medicine and Health Sciences ; Nutrition ; Patients ; People and Places ; Pharmacy ; R&D ; Reduction ; Research & development ; Resource utilization ; Social Sciences ; Surgery ; Utilization</subject><ispartof>PloS one, 2021-07, Vol.16 (7), p.e0254807-e0254807</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Miyazaki et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Miyazaki et al 2021 Miyazaki et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c669t-aae045b8f2d34c8d1911ea00c00ec1b817bc96922382d533cd3319b3d238b5203</citedby><cites>FETCH-LOGICAL-c669t-aae045b8f2d34c8d1911ea00c00ec1b817bc96922382d533cd3319b3d238b5203</cites><orcidid>0000-0002-0224-563X ; 0000-0002-9201-181X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8289035/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8289035/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids></links><search><creatorcontrib>Miyazaki, Celine</creatorcontrib><creatorcontrib>Katsumasa, Nagano</creatorcontrib><creatorcontrib>Huang, Kuan Chih</creatorcontrib><creatorcontrib>Liu, Yan Fang</creatorcontrib><title>Evaluation of economic burden with biologic treatments in Crohn’s disease patients: A mirror image study using an insurance database in Japan</title><title>PloS one</title><description>Biologics are recommended in Japan to treat moderate to severe Crohn’s Disease (CD). Although CD is associated with high direct costs in Japan, updated information after ustekinumab’s approval is unavailable. We aimed to evaluate the healthcare resource utilization (HRU) and associated direct costs from the payer’s perspective in Japan. Claims data (2010–2018) were retrospectively analyzed to identify patients with CD. HRU and associated costs were evaluated for 12 months before and after biologic initiation and followed-up till 36 months post-initiation. Outcomes were reported using descriptive statistics. Among the included patients (n = 3,496), 1,783 were on biologics and 1,713 were on non-biologics. Mean (SD) age was 36.4 (13.2) years and patients were predominantly male (76.1%). Patients aged 18–39 years were affected with CD the most (55.3%). Biologic initiation was associated with a reduction in inpatient stay, length of stay, outpatient visits, and associated costs; and an increase in pharmacy costs and total costs after 12 months. Extended follow-up showed a decreasing trend in HRU and costs till 24 months but an increase after 36 months. These findings demonstrated reduction in clinical burden and slight increase in economic burden with biologics. However, indirect costs also need to be evaluated.</description><subject>Adults</subject><subject>Biological products</subject><subject>Biological treatment</subject><subject>Biology and Life Sciences</subject><subject>Care and treatment</subject><subject>Comorbidity</subject><subject>Cost analysis</subject><subject>Cost estimates</subject><subject>Costs</subject><subject>Crohn's disease</subject><subject>Disease</subject><subject>Economics</subject><subject>Employees</subject><subject>Enteral nutrition</subject><subject>Epidemiology</subject><subject>Evaluation</subject><subject>Health economics</subject><subject>Insurance coverage</subject><subject>Medical care</subject><subject>Medical care, Cost of</subject><subject>Medicine and Health Sciences</subject><subject>Nutrition</subject><subject>Patients</subject><subject>People and Places</subject><subject>Pharmacy</subject><subject>R&D</subject><subject>Reduction</subject><subject>Research & development</subject><subject>Resource utilization</subject><subject>Social Sciences</subject><subject>Surgery</subject><subject>Utilization</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNk81u1DAQxyMEoqXwBkhYQkJw2MUfSTbhgLRaFVhUqRJfV2tiT7KusvZiO4XeeAPOvB5PgsMuqEE9oBwcjX_zH89fM1n2kNE5Ewv2_MIN3kI_3zmLc8qLvKKLW9kxqwWflZyK29f-j7J7IVxQWoiqLO9mRyLnFeU5P86-n15CP0A0zhLXElTOuq1RpBm8Rku-mLghjXG961IweoS4RRsDMZasvNvYn99-BKJNQAhIdklnvH1BlmRrvHeemC10SEIc9BUZgrEdAZuSw-DBKiQaIjRjatJ7Czuw97M7LfQBHxzOk-zjq9MPqzezs_PX69XybKbKso4zAKR50VQt1yJXlWY1YwiUKkpRsaZii0bVZc25qLguhFBaCFY3QqdAUyRHTrJHe91d74I8eBkkLwrBWU0XI7HeE9rBhdz51Im_kg6M_B1wvpPgo1E9SkRdlAvNVUmLnC94gyVtVd0yDalkhUnr5aHa0GxRq2SSh34iOr2xZiM7dykrXtVUFEng6UHAu88Dhii3Jijse7Dohv27Cy5EPr778T_ozd0dqA5SA8a2LtVVo6hcJocpp2XFEzW_gUqfxjQkafBak-KThGeThMRE_Bo7GEKQ6_fv_p89_zRln1xjNwh93ATXD-PchimY70HlXQge278mMyrHvfnjhhz3Rh72RvwC55MLbQ</recordid><startdate>20210719</startdate><enddate>20210719</enddate><creator>Miyazaki, Celine</creator><creator>Katsumasa, Nagano</creator><creator>Huang, Kuan Chih</creator><creator>Liu, Yan Fang</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-0224-563X</orcidid><orcidid>https://orcid.org/0000-0002-9201-181X</orcidid></search><sort><creationdate>20210719</creationdate><title>Evaluation of economic burden with biologic treatments in Crohn’s disease patients: A mirror image study using an insurance database in Japan</title><author>Miyazaki, Celine ; Katsumasa, Nagano ; Huang, Kuan Chih ; Liu, Yan Fang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c669t-aae045b8f2d34c8d1911ea00c00ec1b817bc96922382d533cd3319b3d238b5203</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adults</topic><topic>Biological products</topic><topic>Biological treatment</topic><topic>Biology and Life Sciences</topic><topic>Care and treatment</topic><topic>Comorbidity</topic><topic>Cost analysis</topic><topic>Cost estimates</topic><topic>Costs</topic><topic>Crohn's disease</topic><topic>Disease</topic><topic>Economics</topic><topic>Employees</topic><topic>Enteral nutrition</topic><topic>Epidemiology</topic><topic>Evaluation</topic><topic>Health economics</topic><topic>Insurance coverage</topic><topic>Medical care</topic><topic>Medical care, Cost of</topic><topic>Medicine and Health Sciences</topic><topic>Nutrition</topic><topic>Patients</topic><topic>People and Places</topic><topic>Pharmacy</topic><topic>R&D</topic><topic>Reduction</topic><topic>Research & development</topic><topic>Resource utilization</topic><topic>Social Sciences</topic><topic>Surgery</topic><topic>Utilization</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Miyazaki, Celine</creatorcontrib><creatorcontrib>Katsumasa, Nagano</creatorcontrib><creatorcontrib>Huang, Kuan Chih</creatorcontrib><creatorcontrib>Liu, Yan Fang</creatorcontrib><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agricultural Science Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Miyazaki, Celine</au><au>Katsumasa, Nagano</au><au>Huang, Kuan Chih</au><au>Liu, Yan Fang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evaluation of economic burden with biologic treatments in Crohn’s disease patients: A mirror image study using an insurance database in Japan</atitle><jtitle>PloS one</jtitle><date>2021-07-19</date><risdate>2021</risdate><volume>16</volume><issue>7</issue><spage>e0254807</spage><epage>e0254807</epage><pages>e0254807-e0254807</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Biologics are recommended in Japan to treat moderate to severe Crohn’s Disease (CD). Although CD is associated with high direct costs in Japan, updated information after ustekinumab’s approval is unavailable. We aimed to evaluate the healthcare resource utilization (HRU) and associated direct costs from the payer’s perspective in Japan. Claims data (2010–2018) were retrospectively analyzed to identify patients with CD. HRU and associated costs were evaluated for 12 months before and after biologic initiation and followed-up till 36 months post-initiation. Outcomes were reported using descriptive statistics. Among the included patients (n = 3,496), 1,783 were on biologics and 1,713 were on non-biologics. Mean (SD) age was 36.4 (13.2) years and patients were predominantly male (76.1%). Patients aged 18–39 years were affected with CD the most (55.3%). Biologic initiation was associated with a reduction in inpatient stay, length of stay, outpatient visits, and associated costs; and an increase in pharmacy costs and total costs after 12 months. Extended follow-up showed a decreasing trend in HRU and costs till 24 months but an increase after 36 months. These findings demonstrated reduction in clinical burden and slight increase in economic burden with biologics. However, indirect costs also need to be evaluated.</abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>34280242</pmid><doi>10.1371/journal.pone.0254807</doi><tpages>e0254807</tpages><orcidid>https://orcid.org/0000-0002-0224-563X</orcidid><orcidid>https://orcid.org/0000-0002-9201-181X</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2021-07, Vol.16 (7), p.e0254807-e0254807 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2553219070 |
| source | DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Adults Biological products Biological treatment Biology and Life Sciences Care and treatment Comorbidity Cost analysis Cost estimates Costs Crohn's disease Disease Economics Employees Enteral nutrition Epidemiology Evaluation Health economics Insurance coverage Medical care Medical care, Cost of Medicine and Health Sciences Nutrition Patients People and Places Pharmacy R&D Reduction Research & development Resource utilization Social Sciences Surgery Utilization |
| title | Evaluation of economic burden with biologic treatments in Crohn’s disease patients: A mirror image study using an insurance database in Japan |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-08T04%3A59%3A43IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Evaluation%20of%20economic%20burden%20with%20biologic%20treatments%20in%20Crohn%E2%80%99s%20disease%20patients:%20A%20mirror%20image%20study%20using%20an%20insurance%20database%20in%20Japan&rft.jtitle=PloS%20one&rft.au=Miyazaki,%20Celine&rft.date=2021-07-19&rft.volume=16&rft.issue=7&rft.spage=e0254807&rft.epage=e0254807&rft.pages=e0254807-e0254807&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0254807&rft_dat=%3Cgale_plos_%3EA669020682%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2553219070&rft_id=info:pmid/34280242&rft_galeid=A669020682&rft_doaj_id=oai_doaj_org_article_eed567d2c6054272be60fc9f1dab3d8e&rfr_iscdi=true |