Patient Attitudes and Preferences for Outcomes of Inflammatory Bowel Disease Therapeutics

The investigators will conduct a comparative effectiveness study among Medicare Parts A, B, and D beneficiaries with inflammatory bowel disease. The investigators will compare the incidence of severe infection, bowel resection surgery, and death among new users of anti-tumor necrosis factor therapies and corticosteroids. The investigators will compute propensity scores to describe the propensity for treatment with anti-tumor necrosis factor drugs compared to corticosteroids, and will match corticosteroids and anti-tumor necrosis factor drug treated patients on the propensity score. Cox regression will be employed to assess the hazard ratio for each of the outcomes.

Inclusion criteria

• Patients will be required to have at least two diagnosis of inflammatory bowel disease within the 6 months prior to initiating anti-TNF therapy or corticosteroids. To assure full coverage, patients will be required to have Parts A, B, and D Medicare coverage.

Exclusion criteria

• Diagnosis of rheumatoid arthritis, psoriasis, ankylosing spondylitis, or psoriatic arthritis in the 6 months period prior to initiation of the therapy.
• Less than 6 months of follow-up time within the data source prior to initiation of the therapy.
• Diagnosis of cancer in the 6 months prior to initiation of the study medication.
• Initiation of anti-TNF therapies within the first 6 months following surgery.
• Patients who are in managed care plans (Medicare Part C).