A recent study from UCLA Health has found that taking a daily 8-strain probiotic may help reduce the risk of pouchitis, an inflammatory condition that can occur after colon removal surgery for ulcerative colitis. However, researchers report that the cost of this treatment may not be justified for most patients unless they are at high risk for repeated flare-ups.
The research, published in Gastro Hep Advances, is the first to assess whether this probiotic approach is cost-effective. Earlier studies had shown that these probiotics could prevent both initial and recurring cases of pouchitis. The new analysis confirmed their effectiveness but raised questions about their value given current prices.
“Our findings highlight that while probiotic treatments can reduce the risk of this complication, their high costs limit their overall value for most patients,” said Dr. Syal, lead author and inflammatory bowel disease gastroenterologist at UCLA. “Our analysis can help guide shared decision-making between patients, clinicians and payers to ensure resources are used where they can provide the most benefit.”
Pouchitis often affects people who have had both their colon and rectum removed due to ulcerative colitis. In these surgeries, doctors create a new internal pouch using part of the small intestine so patients do not need an external waste bag. If this pouch becomes inflamed—pouchitis—patients may experience frequent or urgent bowel movements, abdominal pain, or bloody stools. The condition is usually treated with antibiotics but can return in some cases.
To determine if daily probiotics were worth the expense to insurers such as Medicare or private companies, UCLA researchers used a computer model tracking pouchitis risks over two years. They found that:
– Probiotic treatment was almost ten times more expensive ($2,200 vs $299) than no probiotics when trying to prevent an initial episode.
– For preventing infrequent recurrences (less than two per year), it was six times more costly ($3,370 vs $557).
– Probiotics only became cost-effective for those experiencing two or more relapses annually.
Dr. Syal said these results could inform discussions between doctors and patients about treatment options and also help policymakers decide how best to allocate healthcare funding.
