Increasing Prevalence and Direct Health Care Cost of Inflammatory Bowel Disease Among Adults: A Population-Based Study From a Western Canadian Province

Abstract

Objectives Our study aimed to calculate the prevalence and estimate the direct health care costs of inflammatory bowel disease (IBD), and test if trends in the prevalence and direct health care costs of IBD increased over two decades in the province of Saskatchewan, Canada. Methods We conducted a retrospective population-based cohort study using administrative health data of Saskatchewan between 1999/2000 and 2016/2017 fiscal years. A validated case definition was used to identify prevalent IBD cases. Direct health care costs were estimated in 2013/2014 Canadian dollars. Generalized linear models with generalized estimating equations tested the trend. Annual prevalence rates and direct health care costs were estimated along with their 95% confidence intervals (95%CI). Results In 2016/2017, 6468 IBD cases were observed in our cohort; Crohn’s disease: 3663 (56.6%), ulcerative colitis: 2805 (43.4%). The prevalence of IBD increased from 341/100,000 (95%CI 340 to 341) in 1999/2000 to 664/100,000 (95%CI 663 to 665) population in 2016/2017, resulting in a 3.3% (95%CI 2.4 to 4.3) average annual increase. The estimated average health care cost for each IBD patient increased from $1879 (95%CI 1686 to 2093) in 1999/2000 to $7185 (95%CI 6733 to 7668) in 2016/2017, corresponding to an average annual increase of 9.5% (95%CI 8.9 to 10.1). Conclusions Our results provide relevant information and analysis on the burden of IBD in Saskatchewan. The evidence of the constant increasing prevalence and health care cost trends of IBD needs to be recognized by health care decision-makers to promote cost-effective health care policies at provincial and national levels and respond to the needs of patients living with IBD.

Increasing Prevalence and Stable Incidence Rates of Inflammatory Bowel Disease Among First Nations: Population-Based Evidence From a Western Canadian Province

“…2,8 All of these studies agree on the increasing prevalence of IBD across regions and population groups. However, when comparing our findings with population-based studies in the general population, we observed that the average annual increase in the prevalence of IBD among FNs (4.2%) was higher than that among the general population of Saskatchewan (3.4%) 37 and Canada (2.9%). 13 This comparison highlights the potentially higher rate of increase in the prevalence of IBD among FNs in comparison to the rate in the general population.…”

Inequities in Rural and Urban Health Care Utilization Among Individuals Diagnosed With Inflammatory Bowel Disease: A Retrospective Population-Based Cohort Study From Saskatchewan, Canada

“…The PDP data have information on every dispensed outpatient prescription medication regardless of coverage or how the claim was paid (either by the federal or provincial government, patients, or private insurance companies) ( 18 ). Over the counter and medications administered in the hospital setting are not captured by this database.…”

The 2023 Impact of Inflammatory Bowel Disease in Canada: Direct Health System and Medication Costs

“…Hospitalization costs directly attributable to Crohn’s disease decreased between 2005 and 2015, from $2,565 to $1,426 per person with Crohn’s disease per year; hospitalization costs attributable to ulcerative colitis remained steady (costs in 2015 Canadian dollars [CAD]) ( 1 ). In Alberta, British Columbia, and Saskatchewan, hospitalization costs ranged from $2,372 to $4,472 per person with IBD per year (Alberta and British Columbia cost in 2020 CAD; Saskatchewan costs in 2013 CAD) ( 7 , 8 ). Hospitalization costs accounted for 35% to 45% of health system costs in 2009, decreasing to 22% to 28% in 2015 ( 7 ).…”

“…Total direct healthcare costs (including medication costs) in the year following a biologic start in Manitoba were $42,876 per person per year, compared to $5,153 in the year prior to the biologic start; costs were sustained among those staying on their biologic (costs are in 2015 CAD) ( 20 ). Medication costs in Saskatchewan significantly increased from an average of $660 (95% CI: $595, $732) per person per year in 1999/00 to $6,530 (95% CI: $6,024, $7,078) in 2016/17 (costs are in 2013 CAD) ( 8 ). Similar increases in cost were reported in Manitoba between 2005 and 2015, where costs of antiTNFs increased from $181 per person per year to $5,720 per person per year (costs are in 2015 CAD) ( 1 ).…”

“…People with higher healthcare costs were more likely to have Crohn’s disease, have an ED visit at the time of diagnosis, be of older age at diagnosis, and have one or more healthcare encounters for a mental health concern. A Saskatchewan study reported an annual increase of 9.5% (95% CI: 8.9, 10.1) in total direct costs, increasing from $1,879 (95% CI: $1,686, $2,093) per person in 1999 to $7,815 (95% CI: $6,733, $7,667) per person in 2016 (costs in 2013 CAD) ( 8 ).…”