In Poland, there are few data concerning the epidemiology of inflammatory bowel disease, including Crohn's disease and ulcerative colitis. However, since 2009 the National Health Fund (Narodowy Fundusz Zdrowia), the sole public-health insurer in Poland, has been running an electronic database of health services that comprises individually reported data claimed to the payer by service providers. We therefore draw on that source in this article, in order to estimate the prevalence and incidence of the disease in respect of cases assigned a K50 or K51 diagnosis under the International Statistical Classification of Diseases and Related Health Problems (ICD-10). On this basis, we were able to demonstrate a substantial increase in the disease burden over the years 2009-2020. We believe these data are of importance at the national level, and may also prove useful as the changing epidemiology of inflammatory bowel disease in Europe is analyzed.
To the best of our knowledge, this article is the first to describe the population of Polish patients suffering from inflammatory bowel diseases (IBDs) and treated with innovative biologic drugs, which are the best treatment options known for patients with moderate to severe disease courses. Using administrative data, we estimate and discuss the significant differences in the use of biologic drugs across different regions of the country. We also show a higher treatment rate for men, compared to women, as well as a high and growing rate for the youngest population. Access to modern therapies is crucial for improving quality of life for the substantially growing population of IBD patients. We believe our work will be a helpful reference for evaluating the current situation of those patients and for predicting future demands.
Background The number of patients in Poland diagnosed with ulcerative colitis (UC) or Crohn’s disease (CD) has been increasing in the last decade, which implies an increase in the number of severe cases, where biologic treatment is required. The aim of this study was to analyse the usage of biologic treatment among patients with both types of inflammatory bowel diseases (IBD) in Poland that was reimbursed by the National Health Fund (NFZ) in 2020. Methods The analysis was conducted using administrative data collected since the year 2009 by the National Health Fund (NFZ), the only public payer in Poland. We defined an IBD patient receiving biologic treatment as a patient: (1) who had at least two inpatient/outpatient records in the NFZ registry in the years 2009 – 2020 with ICD10 code K50/K51 assigned; (2) who had filled at least two prescriptions for IBD medications two months apart or who had undergone intestinal surgery prior to the record; (3) and who received biological treatment reimbursed by the NFZ in 2020. We assessed the total percentage of patients with each diagnosis who received biologic treatment as well as the percentage by sex, by age group and by the place of residence (voivodeship). Results In 2020, the percentage of patients treated with biologic agents in the population of CD patients was 7.9% (1 863 / 23 574). The percentage of patients treated with biologic agents in the population of UC patients was 1.6% (1 174/73 235). The rate of patients treated with biologics for both CD and UC was significantly lower in women than in men (p<0,001 for both). Among all age groups, the highest percentage of patients receiving biologic treatment for both CD and UC (21,7% and 6,5%, respectively) was observed in those aged 10–19 years and the lowest percentage in patients aged over 70 years (0,8% for CD, 0,2% for UC). The highest proportion of patients treated with biologic drugs among CD patients was found in the Mazovian Voivodeship (13.8%) and the lowest - in the Lubusz Voivodeship (1.2%). In UC, the highest biologic treatment rate was observed in the Świętokrzyskie Voivodeship (3.1%), and the lowest in the Lubusz Voivodeship and the Warmian-Masurian Voivodeship (both 0.2%). Conclusion The use of biologic agents in the treatment of both Crohn’s disease and ulcerative colitis in Poland has been presented. Female patients receive biologic treatment for IBD significantly less frequently than male. The highest proportion of patients receiving biologic treatment for both CD and UC was found in the paediatric population. There are voivodeships in Poland where the access to biological treatment is unacceptably low.
Background The epidemiology of inflammatory bowel disease (IBD) in Poland has only been recognised to a limited extent. We aimed to estimate the prevalence and incidence of the disease by analysing data from the National Health Fund, the sole public health insurer. Methods Administrative health claims collected over the 2009–2020 period were used to identify patients with Crohn’s disease (CD) or ulcerative colitis (UC). A definition of a case comprised ≥2 records assigned K50 or K51 codes, plus ≥2 prescriptions for IBD drugs reimbursed, or else intestinal surgery preceding the record. The crude and European age-standardised rates (EASR) and 95% confidence intervals (CI) were calculated for the prevalence and incidence. Time trends were also analysed. Results As of 2020 there were 23,574 patients with CD and 73,235 with UC. The CD and UC prevalence was respectively 61.6 [EASR 60.3 (95% CI 59.5–61.0)] and 191.4 [EASR 187.85 (95% CI 186.5–189.2)] per 100,000. The prevalence of CD was higher in men [64.1; EASR 61.3 (95% CI 60.2–62.5)] than in women [59.3; EASR 58.4 (95% CI 57.3-59,5)]. Similarly, the prevalence of UC was higher in men [201.4; EASR 202.7 (95% CI 200.5–204.8)] than in women [182.0; EASR 175.5 (95% CI 173.7–177. 4)]. The incidence of CD was 4.7 per 100 000 [EASR 4.6 (95% CI 4.4–4.8)], while of UC 12.5 [EASR 12.3 (95%CI 12.0–12.7)]. Through the period 2012–2018, the prevalence of both conditions rose, even as downward trends were noted for disease incidence. Conclusion The prevalence and incidence of IBD in Poland are presented, with time trends showing substantial increase in the disease burden over the years 2009–2020.
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