Cost Burden of Crohn’s Disease and Ulcerative Colitis in the 10-Year Period Before Diagnosis—A Danish Register-Based Study From 2003–2015

Vadstrup, Kasper; Alulis, Sarah; Borsi, András; Gustafsson, Nina; Nielsen, A.; Wennerström, E. Christina M.; Jørgensen, Tine Rikke; Qvist, Niels; Munkholm, Pia

doi:10.1093/ibd/izz265

Cited by 33 publications

(30 citation statements)

References 22 publications

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“…A sensitivity analysis applying the fourth year before diagnosis as the baseline year suggests that the attributable cost estimates presented in this study are conservative. Analyses on costs before the diagnosis with CD or UC are also investigated by our group and published in a separate article [14].…”

Section: Discussionmentioning

confidence: 99%

Societal costs attributable to Crohn’s disease and ulcerative colitis within the first 5 years after diagnosis: a Danish nationwide cost-of-illness study 2002–2016

Vadstrup¹,

Alulis²,

Borsi

et al. 2020

Scandinavian Journal of Gastroenterology

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Objective: There is little information on cost-of-illness among patients diagnosed with Crohn's disease (CD) and ulcerative colitis (UC) in Denmark. The objective of this study was to estimate the average 5year societal costs attributable to CD or UC patients in Denmark with incidence in 2003-2015, including costs related to health care, prescription medicine, home care and production loss. Materials and methods: A national register-based, cost-of-illness study was conducted using an incidence-based approach to estimate societal costs. Incident patients with CD or UC were identified in the National Patient Registry and matched with a non-IBD control from the general population on age and sex. Attributable costs were estimated applying a difference-indifference approach, where the total costs among individuals in the control group were subtracted from the total costs among patients. Results: CD and UC incidence fluctuated but was approximately 14 and 31 per 100,000 person years, respectively. The average attributable costs were highest the first year after diagnosis, with costs equalling e12,919 per CD patient and e6,501 per UC patient. Hospital admission accounted for 36% in the CD population and 31% in the UC population, the first year after diagnosis. Production loss exceeded all other costs the third-year after diagnosis (CD population: 52%; UC population: 83%). Conclusions: We found that the societal costs attributable to incident CD and UC patients are substantial compared with the general population, primarily consisting of hospital admission costs and production loss. Appropriate treatment at the right time may be beneficial from a societal perspective.

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Section: Discussionmentioning

confidence: 99%

Societal costs attributable to Crohn’s disease and ulcerative colitis within the first 5 years after diagnosis: a Danish nationwide cost-of-illness study 2002–2016

Vadstrup¹,

Alulis²,

Borsi

et al. 2020

Scandinavian Journal of Gastroenterology

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“…The first recorded diagnosis of CD available in the database may not be the first diagnosis of CD in the patient's history. This implies that the burden of CD was likely underestimated, as the healthcare costs among CD patients peak in the year before diagnosis 31 . The diagnosis and severity of CD (e.g.…”

Section: Limitationsmentioning

confidence: 99%

Burden of Crohn’s disease in the United States: long-term healthcare and work-loss related costs

Manceur

Ding

Muser

et al. 2020

Journal of Medical Economics

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Aims: To quantify the long-term direct and indirect costs among patients with Crohn's disease (CD) and specific subgroups of these patients in the United States from the private payer's perspective. Materials and methods: This retrospective study used the OptumHealth Care Solutions, Inc database (01 January 1999-31 March 2017) to match (1:5) adult patients with !2 claims for CD to patients without inflammatory bowel disease (IBD). Patterns observed during follow-up (i.e. biologics, opioids, or steroids; CD-related surgery; moderate-to-severe disease; and comorbidities) were used to identify CD subgroups. Comparisons of healthcare resource utilization, work loss days, and direct and indirect work loss-related costs were made between matched cohorts. Descriptive analyses of costs were conducted within each CD subgroup. Results: There were 6,715 and 33,575 patients in the CD and non-IBD cohorts, respectively. The direct burden was significantly higher in the CD cohort compared to the non-IBD cohort, with 0.34 inpatient admissions per patient per year (PPPY) versus 0.12 (217% increase; p < .

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“…It is possible that some environmental factors, such as diet, tobacco smoking, air pollution, infections or drugs, play an important role as triggers for disease initiation and progression. Interestingly, the presence of a pre-symptomatic period in IBD is suggested by the increased costs associated with healthcare use in the years previous to the diagnosis in CD and UC patients, but a possible bias due to a diagnostic delay should be considered in this type of analysis [ 52 ]. Thus, an uncontrolled inflammatory process arising in the gut, which may also be associated with extraintestinal manifestations and non-specific symptoms (e.g., asthenia, weight loss), may precede the final diagnosis of an underlying disorder like IBD.…”

Section: Preclinical Ibdmentioning

confidence: 99%

Diagnosis and natural history of preclinical and early inflammatory bowel disease

Rodríguez‐Lago

Zabana

Acosta

2020

aog

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Inflammatory bowel disease is a chronic and progressive disorder of the gastrointestinal tract. A relevant proportion of patients develop complicated lesions, defined as strictures, fistulas and/or abscesses already at diagnosis, and this proportion increases over time. The preclinical phase defines the period of time from the appearance of the first immune disturbances until the development of overt disease, and it may be present months to years before the diagnosis. Multiple biomarkers (e.g., C-reactive protein, interleukin-6, fecal calprotectin) and cellular mechanisms (e.g., complement cascade, lysosomes, innate immunity, and glycosaminoglycan metabolism) are already altered during this period. Research in this area allows the description of the initial immune disturbances that may identify potential targets and lead to the development of new drug therapies. During this period, different interventions in high-risk individuals, including drugs or environmental factors, will open the possibility of innovative strategies focused on the reduction of complications, or even prevention trials for inflammatory bowel disease. Here, we review the most relevant findings regarding the characteristics, prevalence and biomarkers associated with preclinical disease, along with their possible use in our future clinical practice.

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Cost Burden of Crohn’s Disease and Ulcerative Colitis in the 10-Year Period Before Diagnosis—A Danish Register-Based Study From 2003–2015

Cited by 33 publications

References 22 publications

Societal costs attributable to Crohn’s disease and ulcerative colitis within the first 5 years after diagnosis: a Danish nationwide cost-of-illness study 2002–2016

Societal costs attributable to Crohn’s disease and ulcerative colitis within the first 5 years after diagnosis: a Danish nationwide cost-of-illness study 2002–2016

Burden of Crohn’s disease in the United States: long-term healthcare and work-loss related costs

Diagnosis and natural history of preclinical and early inflammatory bowel disease

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