Resource use and societal costs for Crohnʼs disease in Sweden

Mesterton, Johan; Jönsson, Linus; Almér, Sven; Befrits, Ragnar; Friis-Liby, Ingalill; Lindgren, Stefan

doi:10.1002/ibd.20939

Cited by 32 publications

(32 citation statements)

References 25 publications

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“…However, only absenteeism among patients with occupational activity and loss of leisure time among unemployed patients were included in the study [4]. Mesterton et al [45] estimated the indirect cost of CD in Sweden at €465 per patient per four weeks (absenteeism and presenteeism), which was nearly two times higher than that in our study (€250.48).…”

Section: Discussionmentioning

confidence: 64%

Health-Related Quality of Life Impairment and Indirect Cost of Crohn’s Disease: A Self-Report Study in Poland

et al. 2016

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Background and AimsEvidence on indirect cost of Crohn’s disease (CD) is available but typically provides information on the loss of productivity at paid work of patients. In the present study, the quality of life and indirect costs of CD patients were assessed (overall and by disease severity).MethodsA self-report questionnaire-based study among adult Polish patients with CD was performed. We collected data on patients’ characteristics, quality of life, loss of productivity, consumption of medical resources, and out-of-pocket expenses. The disease severity was determined using the patient’s version of the Harvey-Bradshaw index. Productivity costs were assessed from the social perspective, using a human capital approach. The cost of absenteeism, presenteeism and permanent work disability was valuated using the gross domestic product per worker. The patients’ productivity loss at unpaid work was measured by time inputs of others to assist patients. The productivity loss among informal caregivers and patients’ productivity loss at unpaid work were valuated with the average wage in Poland. The results were adjusted for confounders.ResultsThe responses from 200 patients (47% in remission) were analysed. The mean utility index was 0.839 (SD 0.171). The total indirect cost was estimated at €462.47 per patient per month (24.0%, absenteeism; 35.0%, work disability; 30.4%, presenteeism; 0.4%, productivity loss at unpaid work; and 10.4%, informal care). A significant correlation of the quality of life and productivity losses with disease severity was observed. Compared with active disease, the remission subgroup had a higher utility index by 16% (p<0.001) and lower indirect costs by 71% (p = 0.003) for absenteeism, 41% (p = 0.030) for presenteeism, 76% (p<0.001) for productivity loss at unpaid work, and 75% (p<0.001) for informal care.ConclusionsOur study revealed the social burden of CD and high dependency of indirect costs and quality of life on the severity of CD in Poland.

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Section: Discussionmentioning

confidence: 64%

Health-Related Quality of Life Impairment and Indirect Cost of Crohn’s Disease: A Self-Report Study in Poland

et al. 2016

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“…All of the identified studies estimated costs that resulted from absenteeism. Only two papers also included those costs that resulted from presenteeism [12,16]. In one study, This systematic review discovered a great range of costs, from US$515.67 per year per patient [27] to US$14,727.05 per year per patient [20] for scenario 1 and from US$532.99 per year per patient [27] to US$ 25,194.92 per year per patient [12] for scenario 2.…”

Section: Resultsmentioning

confidence: 98%

“…† absenteeism only, presenteeism only and for studies considering both absenteeism and presenteeism as those two phenomena are incomparable. Unfortunately, out of the two studies concerning presenteeism [12,16], only one of them [12] presented enough data to be eligible for meta-analysis; therefore, such analysis was not performed, and meta-analysis was performed only for studies concerning absenteeism. Only those studies that presented the number of patients, mean costs and standard deviation (standard error or confidence intervals), or those that made it possible to easily calculate such data were eligible for meta-analysis.…”

Section: Resultsmentioning

confidence: 99%

“…Six studies concerned only Crohn's disease [13][14][15][16][17][18], one referred only to ulcerative colitis [19] and 11 studies concerned inflammatory bowel diseases in general [12,[20][21][22][23][24][25][26][27][28][29]. Out of the 18 publications included in this review, nine reported costs for North America, [17][18][19][23][24][25][26][27][28], eight for Europe [12][13][14]16,[20][21][22]29] and one for New Zealand [15]. Eight studies did not report the methodology used for the estimation of indirect costs, but based on the description it was the Human Capital Approach (HCA).…”

Section: Resultsmentioning

confidence: 99%

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Indirect health costs in ulcerative colitis and Crohn’s disease: a systematic review and meta-analysis

Kawalec¹,

Malinowski

2015

Expert Review of Pharmacoeconomics & Outcomes Research

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The aim of this systematic review was to collect all current data on indirect costs related to inflammatory bowel disease as well as assessing homogeneity and comparability, and conducting a meta-analysis. Costs were collected using databases from Medline, Embase and Centre for Reviews and Dissemination databases, then average annual cost per patient was calculated and expressed in 2013-rate USD using the consumer price index and purchasing power parity (scenario 1) and then adjusted to specific gross domestic product (scenario 2) to make them comparable. The studies were then included in quantitative synthesis using the meta-analysis and bootstrap methods. This systematic review was carried out and reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. From 18 publications, overall annual indirect costs per patient as a result of the quantitative synthesis among all studies eligible for meta-analysis ranged from US$2425.01-US$9622.15 depending on the scenario and model used for analysis. The cost of presenteeism was assessed in only two studies. Considering heterogeneity among all identified studies random-effect model presented the most accurate results of meta-analysis equal to US$7189.27 and US$9622.15 per patient per year for scenario 1 and scenario 2, respectively. This systematic review revealed the existence of a relatively small number of studies that reported on the great economic burden of the disease upon society. A great variety of methodologies and cost components resulted in a very large discrepancy in indirect costs and made meta-analysis difficult to perform, so two scenarios were considered and meta-analysis conducted in subgroups to make data more comparable.

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“…Several studies have shown that patients with CD present significant absenteeism and reduced productivity 3,31,32 ; others have shown that indirect costs derived from lost productivity may be even greater than those from direct health care costs and that these costs increase proportionally with the severity of the disease. 33,34 A meta-analysis including 1020 patients with CD treated with adalimubab showed a major improvement in productivity and therefore a decrease in indirect costs. 35 Thus, the availability of a shortened questionnaire on perceived work disability might help to determine the impact of different treatments.…”

Section: Discussionmentioning

confidence: 99%

Development and Validation of the Short Crohnʼs Disease Work Disability Questionnaire

Vergara

Sicilia

Prieto

et al. 2016

Inflammatory Bowel Diseases

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Resource use and societal costs for Crohnʼs disease in Sweden

Abstract: Patients in remission have the lowest costs and the highest HRQoL. Patients responding to treatment have lower costs of care than patients with high disease activity who are not treated or do not respond to treatment. Thus, total costs of care might be reduced by efficient treatment.

Cited by 32 publications

References 25 publications

Health-Related Quality of Life Impairment and Indirect Cost of Crohn’s Disease: A Self-Report Study in Poland

Health-Related Quality of Life Impairment and Indirect Cost of Crohn’s Disease: A Self-Report Study in Poland

Indirect health costs in ulcerative colitis and Crohn’s disease: a systematic review and meta-analysis

Development and Validation of the Short Crohnʼs Disease Work Disability Questionnaire

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