Clinical economics review: irritable bowel syndrome

Abstract

The ubiquitous nature of irritable bowel syndrome (IBS), coupled with a lack of good treatment options, has created the impression that the condition must represent a large drain on health‐care resources. The literature certainly appears to support this view but is largely based on patients seen in referral centres (10–15%) and it may not be appropriate to extrapolate these data to the IBS population as a whole (85–90%).In addition to reviewing such literature that exists on the economics of IBS, this paper contains some new data, which suggest that the direct costs of the condition, certainly in the UK, may not be quite as high as has previously been assumed. This may be partly due to factors such as the low cost of the drugs used to treat the condition and the tendency for many patients to stop consulting because of disenchantment with the inadequacies of current therapy. Conversely, the indirect and intangible costs of the disorder appear to be much greater, but these burdens obviously do not have such an impact on those responsible for purchasing and providing health care for IBS sufferers.Paradoxically, if a new, effective therapy for IBS were forthcoming, the situation could change dramatically, especially if it involved a new drug. Any such agent would inevitably be more expensive than anything available today, leading to a potentially dramatic escalation in the direct costs of this disorder.

Socioeconomic Impact of Irritable Bowel Syndrome in Canada

“…A study by Wells et al (14) estimated that, in 1995, the direct costs associated with this condition over a one-year period in the United Kingdom averaged £45.6 million. The total expenditures were based on the following costs: physician visits (£13.1 million), prescribed medications (£12.5 million), hospital outpatient visits (£16.6 million) and inpatient admissions (£3.4 million).…”

“…Although IBS is not life-threatening, patients report limited and constrained lives that have been modified to cope with their disease. In a study conducted by Wells et al (14), the qualities of lives of patients with different medical afflictions were compared and examined. Mean scores on the Short Form-36 IBS-specific quality of life (IBSQOL) questionnaire for patients with diabetes, acute myocardial infarction, hypertension and clinical depression were compared with the IBS mean for a tertiary care group and with the national norms for nonpatients.…”

Cognitive behavioural therapy in addition to antispasmodic therapy for irritable bowel syndrome in primary care: randomised controlled trial

“…American studies have reported how costly IBS is both in terms of healthcare use and lost productivity, whereas assessments in the UK have been more cautious. [58][59][60][61][62][63][64][65][66] There has been surprisingly little assessment of the opportunity costs of IBS. In addition, although various new pharmaceutical preparations have been trialled there has been little published economic analysis of these treatments.…”

Review: Altering the gastrointestinal flora in patients with functional bowel disorders: a way ahead?

“…Unfortunately, the understanding of the pathogenesis and pathophysiology of these disorders is limited and there are few effective treatment options [Spiller et al 2007]. Moreover, healthcare consumption in this group of patients is high, and since IBS is a very common, chronic disorder with severe symptoms, the economic consequences of the disorder are profound [Wells et al 1997].…”