Healthcare use, work loss and total costs in incident and prevalent Crohn's disease and ulcerative colitis: results from a nationwide study in Sweden

Khalili, Hamed; Everhov, Åsa H; Halfvarson, Jonas; Ludvigsson, Jonas F.; Askling, Johan; Myrelid, Pär; Söderling, Jonas; Olén, Ola; Neovius, Martin

doi:10.1111/apt.15889

Cited by 38 publications

(37 citation statements)

References 32 publications

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“…A key strength of the study is the use of microdata from nationwide registers to identify the study population and inform real-world annual resource use, rather than annualising costs from self-reported information with short recall periods from a sample [ 11 , 18 , 50 , 62 ]. Some bias may have been introduced in requiring 9 years of complete observation.…”

Section: Discussionmentioning

confidence: 99%

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Cost-of-Illness Progression Before and After Diagnosis of Multiple Sclerosis: A Nationwide Register-Based Cohort Study in Sweden of People Newly Diagnosed with Multiple Sclerosis and a Population-Based Matched Reference Group

et al. 2021

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Background Multiple sclerosis (MS) is a chronic disease associated with increased healthcare utilisation and productivity losses.Objective The objective of this study was to explore the progression of healthcare costs and productivity losses before and after diagnosis of MS in comparison to that of a population-based matched reference group. Methods We conducted a nationwide, Swedish register-based cohort study of working-aged people with MS diagnosed in 2010-12 (n = 1988) and population-based matched references without MS (n = 7981). Nine years of observation spanned from 4 years prior (Y −4 ) to 4 years (Y +4 ) after the year of diagnosis (Y 0 ). Differences in annual all-cause healthcare costs (inpatient and specialised outpatient healthcare as well as pharmacy-dispensed prescribed drugs) and costs of productivity loss (days with sickness absence and disability pension) were estimated between the people with MS and references using t tests with 95% confidence intervals. The average excess costs of MS were estimated using generalised estimating equation models. Results People with multiple sclerosis had higher costs before the diagnosis of MS and also thereafter. The mean differences in healthcare costs and productivity losses between the people with MS and matched references in Y −4 were 216 EUR (95% confidence interval 58-374) and 1540 EUR (95% confidence interval 848-2233), with larger cost excesses observed in later study years. Summarising the 9 study years, people with MS had fivefold higher excess healthcare costs than references, and more than twice as high productivity losses. Conclusions Excess healthcare costs and productivity losses occur already before the diagnosis of MS and increase with time. The excess costs findings before diagnosis could suggest that an earlier diagnosis might lead to reduced excess costs of MS over time. Plain Language SummaryMultiple sclerosis (MS) is a neurological disease that can affect many parts of everyday life, including work. We studied the extra costs related to MS. Extra costs were defined as the difference in costs between people with MS and the general population in Sweden. To do this, we compared the costs of working-aged individuals with MS from 4 years before to 4 years after the year of MS diagnosis with those of individuals without MS. For each year, we measured the healthcare consumption and days absent owing to sickness absence or a disability pension. We found that people with MS had larger costs already before the diagnosis of MS. For all types of costs we studied, there were extra costs. The extra costs became larger with time and had a steep increase around the year of MS diagnosis. When we summarised the costs from all 9 years, people with MS had five times higher annual costs related to healthcare consumption than those without MS. There were also twice as high costs for lost production from days absent with sickness absence or a disability pension. While our data from national registers had

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Section: Discussionmentioning

confidence: 99%

“…Population-based matched references were used to estimate the cost excess of MS [ 62 ]. Therefore, costs related to comorbidity and wider problems related to MS were considered.…”

Section: Discussionmentioning

confidence: 99%

Cost-of-Illness Progression Before and After Diagnosis of Multiple Sclerosis: A Nationwide Register-Based Cohort Study in Sweden of People Newly Diagnosed with Multiple Sclerosis and a Population-Based Matched Reference Group

et al. 2021

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“…However, the main cost driver was hospitalisation, while costs of biologics accounted for 11% and 2.6% of CD and UC, respectively 20 . Khalili et al 21 investigated the societal costs including direct costs in register‐identified incident and prevalent adult patients with IBD as compared to the general population in Sweden in relation to the corresponding costs in the general population f IBD in Sweden. The mean health care costs in 2014 were $10 096 for CD and $5926 for UC.…”

Section: Discussionmentioning

confidence: 99%

Trends in paediatric inflammatory bowel disease‐attributable direct costs: a population‐based analysis

El-Matary

Nugent

Witt

et al. 2021

Aliment Pharmacol Ther

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SummaryBackgroundIn addition to its morbidities, inflammatory bowel disease (IBD) has a major financial burden on patients and healthcare systems. However, there is a paucity of evidence on IBD‐attributable costs in children.AimsTo determine the trends of IBD‐attributable direct costs over time using a population‐based analysis.MethodsData were extracted from Manitoba Health Provider Claims and other population registry datasets from 1995 to 2017. Children with IBD were matched by age, sex and location with children without IBD. IBD‐attributable direct costs were calculated using utilization counts from the administrative data and cost estimates from different sources. Inpatient hospitalisation and outpatient procedure costs were estimated using the resource intensity weight (RIW) that is attached to each record in the data. Costs were expressed in Canadian dollars.ResultsWe included 733 (428 with Crohn's disease) prevalent cases who were diagnosed with IBD before the age of 18 years and were followed for 2450 person‐years. A matched control group of 6763 persons who were followed for 21 558 person‐years was included. The median annual costs of physician services billed per patient increased from $381 (IQR 215‐1064) in 1995 to $936 (IQR 579‐1932) in 2017 (P < 0.001). The annual medication costs per patient increased from a median of $270 in 1995 to $7944 in 2017 (P < 0.0001). The median annual direct cost per patient was $1810 in 2004 as compared to $14 791 (P < 0.0001) in 2017.ConclusionsOver two decades, there was a significant increase in the paediatric IBD‐attributable direct costs mainly driven by medication costs.

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“…Many patients with IBD need accommodations at work when working to overcome disability (the employer granting time to go to medical appointments, easy access to a suitable toilet) which was reported as difficult for almost half of the patients in a study of impact on the workplace of IBD in recent study from New Zealand 246 . In a nationwide study to assess costs of actively treated patients with CD and UC in Sweden, the societal cost of incident and prevalent patients with any of the diseases was consistently two to three times higher than the general population with more than 50% originating from productivity losses deriving from sick leave and disability pension 247 .…”

Section: Indirect Costsmentioning

confidence: 99%

Surgery and stomas in Crohn's disease

Kalman

2021

Linköping University Medical Dissertations

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This study investigates the evolution of abdominal surgery in treatment of Crohn´s disease (CD) in the era of immunomodulatory drugs and biologicals. It concerns risk of abdominal surgery overall and sub-categories of abdominal surgery, risk of repeat surgery and factors that affect this risk, and risk of getting a stoma. Surgical recurrence is a major clinical problem as repeat procedures are more complex and expose the patients to a higher medical risk both in conjunction with surgery and afterwards. Updated information on abdominal surgery for CD will be of use when making decisions about medical vs surgical interventions.

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Healthcare use, work loss and total costs in incident and prevalent Crohn's disease and ulcerative colitis: results from a nationwide study in Sweden

Cited by 38 publications

References 32 publications

Cost-of-Illness Progression Before and After Diagnosis of Multiple Sclerosis: A Nationwide Register-Based Cohort Study in Sweden of People Newly Diagnosed with Multiple Sclerosis and a Population-Based Matched Reference Group

Cost-of-Illness Progression Before and After Diagnosis of Multiple Sclerosis: A Nationwide Register-Based Cohort Study in Sweden of People Newly Diagnosed with Multiple Sclerosis and a Population-Based Matched Reference Group

Trends in paediatric inflammatory bowel disease‐attributable direct costs: a population‐based analysis

Surgery and stomas in Crohn's disease

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