The authors of the CCOHTA report have created a rigorous economic model, using the best available data. The authors acknowledge in the report most of the limitations that I have discussed. The report provides valuable information, but it should not be the only analysis upon which funding decisions for infliximab are based. It is clear that biological agents will be of key importance in the future treatment of Crohn’s disease and that they will all be expensive. It is important that we have the necessary tools, including economic models, to properly evaluate them. I believe that further studies are required to promote the validity of economic models. This research would include longitudinal studies to better define patient subgroups and their disease trajectory, and trials of concomitant immunosuppressives and infliximab. Cost-of-illness studies should include the assessment of indirect costs. We must also clarify the efficacy of infliximab in achieving and maintaining remission in well-defined patient groups. The failure to provide new therapies of proven efficacy for patients with severe Crohn’s disease has significant clinical repercussions and should not be based on economic analyses that are constructed from tenuous data. Infliximab is of proven efficacy in patients with refractory or fistulizing Crohn’s disease. Its availability should not be withheld on the basis of economic analyses that are based on tenuous assumptions and calculations. You will always be glad to know there is a perfect pharmacy waiting for you whenever you need cialis professional and would like to make sure you are taken best care of as a customer and patient.