Comparison between washed microbiota transplantation and infliximab - Medical cost during long-term management in patients with inflammatory bowel disease

Q: What treatments does the study compare for long-term IBD management?

The study compares infliximab (IFX) with washed microbiota transplantation (WMT), including WMT as monotherapy and WMT combined with mesalazine.

Q: How were patients selected and followed in the real-world cohort?

Patients with IBD who received initial WMT via endoscopy or enteral tubing between April 2013 and August 2021 and maintained long-term sustainment with WMT (or WMT plus mesalazine) until August 2022 were recruited in the real-world setting.

Q: What were the main cost findings across the treatment groups?

Long-term annual costs and costs per hospitalization were lower with WMT monotherapy than with WMT plus mesalazine, and cumulative IFX costs exceeded those of WMT at later time points; WMT monotherapy also reduced cost and hospitalization duration when patients reached sustainment goals.

Sep 29, 2026

Uploaded by River Wang

Both infliximab (IFX) and fecal microbiota transplantation (FMT) show efficacy for inflammatory bowel disease (IBD), yet cost-value comparisons remain lacking. This study compares medical costs of IFX and washed microbiota transplantation (WMT) for long-term management of IBD under China’s current health-economic conditions, using real-world patient data and analyzing costs and hospitalizations across treatment strategies.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Introduction

Background and clinical context

Methods

Study design and patient cohort

Cost and hospitalization analysis

Results

Long-term costs and hospitalization outcomes

Conclusion

Clinical implications for cost savings

J Chin MedAssoc Original article Comparison between washed microbiota transplantation and infliximab: Medical cost during long-term management in patients with inflammatory bowel disease Sheng Zhanga,b, Yihao Huanga,b, Gaochen Lua,b, Zulun Zhanga,b, Yun Wanga,b, Yujie Liua,b, Weihong Wanga,b, Qianqian Lia,b, Pan Lia,b, Quan Wena,b, Bota Cuia,b, Faming Zhanga,b,c,d,* aDepartment of Microbiota Medicine & Medical Center for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China; bKey Lab of Holistic Integrative Enterology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China; cDepartment of Microbiotherapy, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China; dNational Clinical Research Center for Digestive Diseases, Xi’an, China Abstract Background: Both infliximab (IFX) and fecal microbiota transplantation (FMT) have shown the efficacy for inflammatory bowel disease (IBD) . However, there has no head-to-head study on the cost-value of the such treatments on IBD. This study aimed to compare the medical costs using IFX and the new method of FMT (washed microbiota transplantation [WMT]) in the long-term management for IBD under the current health economic condition in China. Methods: Patients with IBD who underwent initial WMT via upper gastrointestinal endoscopy, mid-gut tube, or colonic transendoscopic enteral tubing at a university hospital between April 2013 and August 2021 and achieved the long-term sustainment with WMT or WMT combined with mesalazine until August 2022 were recruited in the real-world. The costs and hospitalizations were analyzed among two therapies mentioned above and IFX standard therapy. The charge of WMT was stable in the long term at our center, and the charge of IFX came from virtual statistics publicized by China Healthcare Security. Results: Sixty eligible patients with IBD were included in the study. The long-term costs of patients using WMT monotherapy annually or per hospitalization were lower than those on WMT combined with mesalazine, respectively (p < 0.001, respectively) . The cumulative costs of IFX at the time of 0.52 and 0.85 years exceeded that of the above WMT, respectively (p < 0.001, respectively) . Besides, patients on WMT monotherapy paid 51.1 k CNY annually in the nonsustain phase but cut down the costs by 7.2 k CNY and duration of hospitalization by 5.1 days per hospitalization when reaching the goal of sustainment. Conclusion: This study demonstrated that WMT could dramatically reduce the cost and duration of hospitalizations in the longterm sustainment in the current Chinese IBD cohort. Compared with IFX, WMT could be a good way for the patients with IBD achieving long-term sustainment and saving medical costs. Keywords: Fecal microbiota transplantation; Goal; Inflammatory bowel disease; Infliximab; Ulcerative colitis 1. INTRODUCTION Inflammatory bowel diseases (IBDs), including Crohn disease (CD) and ulcerative colitis (UCs), are chronic, progressive immune-mediated diseases of the intestinal tract with relapsing, and remitting courses.1,2 Growing evidence indicates that the * Address correspondence. Dr. Faming Zhang, Department of Microbiota Medicine & Medical Center for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University, 121 Jiang Jia Yuan, Nanjing 210011, China. E-mail address: [fzhang@njmu.edu.cn](fzhang@njmu.edu.cn) (F. Zhang). Author contributions: Dr Sheng Zhang and Dr Yihao Huang contributed equally to this work. Conflicts of interest: The authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article. Journal of Chinese Medical Association. (2024) 87: 109-118. Received February 16, 2023; accepted July 30, 2023. doi: 10. 1097/JCMA.0000000000001025 Copyright © 2023, the Chinese Medical Association. This is an open access article under the CC BY-NC-ND license ([http://cre

FAQs

What treatments does the study compare for long-term IBD management?

The study compares infliximab (IFX) with washed microbiota transplantation (WMT), including WMT as monotherapy and WMT combined with mesalazine.

How were patients selected and followed in the real-world cohort?

Patients with IBD who received initial WMT via endoscopy or enteral tubing between April 2013 and August 2021 and maintained long-term sustainment with WMT (or WMT plus mesalazine) until August 2022 were recruited in the real-world setting.

What were the main cost findings across the treatment groups?

Long-term annual costs and costs per hospitalization were lower with WMT monotherapy than with WMT plus mesalazine, and cumulative IFX costs exceeded those of WMT at later time points; WMT monotherapy also reduced cost and hospitalization duration when patients reached sustainment goals.

Sep 29, 2026

Uploaded by River Wang