Anti-TNF therapy in inflammatory bowel disease: addressing barriers to long-term therapy

Anti-TNF agents represent important therapeutics in Crohn’s disease and ulcerative colitis; however, there are barriers to their long-term use. First, anti-TNF agents represent a major driver of healthcare expenditure, highlighting the need to consider cost-effective alternatives such as biosimilars. Second, a subset of patients that initially respond to anti-TNF therapy subsequently lose response. Hence, this thesis describes strategies that prioritise quality use of medicines to address these barriers by promoting the uptake of biosimilar medicines to realise substantial cost savings for Australian healthcare payers, and adopting innovative ‘virtual’ models-of-care and novel anti-TNF dosing strategies to improve clinical outcomes following loss of response.