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

Abstract

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.

Systematic review: societal cost of illness of inflammatory bowel disease is increasing due to biologics and varies between continents

“…Costs for incident cases peaked in the first year after diagnosis, and then quickly declined and stabilised after two years, driven by a decrease in hospitalisation, surgical and investigation costs. However, the cost decline is partially offset by increased costs for biologics each year after diagnosis 70,71,73,77,92,93 …”

“…Longitudinal data to assess changes in total and component costs for incident cases were not available for different time periods. Most studies reported annual healthcare costs for incident cases in the time period 2008-2012, 42,47,70,71,73,76,92,93,95 and other incidencebased studies reported healthcare costs in the first ten years after diagnosis. 67,77 Mean annual IBD-attributable costs of incident CD and UC cases in the first year after diagnosis were assessed in seven studies (Table 3).…”

Kuijieyuan Decoction Improved Intestinal Barrier Injury of Ulcerative Colitis by Affecting TLR4-Dependent PI3K/AKT/NF-κB Oxidative and Inflammatory Signaling and Gut Microbiota

“…Ulcerative colitis (UC) is a chronic inflammatory disease of the colon caused by unbalanced immune responses to host intestinal microbiota and main threatens to public health ( Roselli and Finamore, 2019 ). Although much progress has been made in diagnosis ( Yang et al., 2019 ; Vadstrup et al., 2020 ) and therapy ( Karjalainen et al., 2020 ; Kunovszki et al., 2020 ) for UC in recent years, an effective therapeutic drug is still difficult to be available. Gut microbiota disturbance ( Noor et al., 2010 ) and intestinal barrier injury ( Chen et al., 2019 ) is often associated with a UC risk.…”

Self-monitoring with home based fecal calprotectin is associated with increased medical treatment. A randomized controlled trial on patients with inflammatory bowel disease

“…Increased incidence [8,9], prevalence [10] and associated costs of IBD [11][12][13] has led to the development of new monitoring strategies such as telemedicine and self-monitoring [14,15]. Telemedicine is healthcare via technologies such as telecommunication or the internet without the patient and healthcare provider being physically present together [4].…”