The Impact of Inflammatory Bowel Disease in Canada 2018: Indirect Costs of IBD Care

Abstract

The indirect cost of illness represents the portion of human capital that is foregone due to lost productivity of patients and their caregivers and out-of-pocket healthcare expenses borne directly by patients. Indirect costs among persons with inflammatory bowel diseases (IBD) may be substantial because disease onset occurs during the teens and 20s for most persons and is lifelong. Thus, most persons with IBD are affected during periods of study or employment. The literature on indirect health-related costs among persons with IBD is limited, particularly with regard to Canadian studies. The greatest burden of indirect costs in this population relates to absenteeism and presenteeism among working individuals and premature retirement. However, costs related to reduced professional development and personal achievement due to illness—as well as caregiver costs—are largely unknown. After being extrapolated from multiple sources, the total indirect health-related cost of IBD in Canada in 2018 is estimated to be $1.29 billion Canadian dollars. Notably, this may be a significant underestimate because costs relating to presenteeism, reduced achievement and caregiver burden could not be estimated and are excluded from this calculation. Highlights Indirect costs account for a major portion of total healthcare costs among persons with inflammatory bowel disease (IBD) and are higher than indirect costs among persons without IBD. Persons with IBD are more likely to require time off work (absenteeism) and have reduced productivity at work (presenteeism) due to illness as compared with persons without IBD. Premature retirement and long-term disability are major factors contributing to indirect costs among IBD patients. A substantial proportion of individuals with IBD pay out-of-pocket for complementary and alternative medicines. After being extrapolated from multiple sources, the total annual indirect cost of IBD in Canada is estimated to be $1.29 billion CAD in 2018, or $4781 CAD per person with IBD. Key Summary Points The total indirect economic burden of IBD in Canada is estimated to be $1.29 billion CAD in 2018, or roughly $4781 CAD per person with IBD. This estimate comprises lost wages related to sick days and disability, premature retirement and premature death, and out-of-pocket costs. Losses from presenteeism, reduced professional development and caregiver burden are not included due to insufficient data on the cost impact of these factors. In a meta-analysis of studies between 1994 and 2014, the annual indirect cost of absenteeism for IBD patients ranged from $515.67 USD (USA) to $14,727 USD (Germany) per patient per annum (pooled estimate $7189 USD), after adjusting for purchasing power disparity. A large US survey found that, on average, IBD patients incurred an extra 4.8 days off of work and $783 USD in exces...

Letter: is unrealised adult height resulting from paediatric Crohn’s disease associated with a potential reduction in lifetime earnings? Authors’ reply

“…To what extent this difference also results in future lost life chances (eg not as good educational results and less well‐paid employments as would have been expected) and reduction in lifetime earnings is yet to be shown. More importantly, many studies have also shown that patients with IBD, regardless of age of diagnosis, have more work loss (sick leave and disability pension) than matched reference individuals or IBD‐free siblings 4‐9 ; these observations to us suggests that it is the disease itself, with its remitting and relapsing disease course, rather than the (limited) reduction in adult height that causes reduced lifetime earnings. That is, if lifetime earnings are indeed reduced, which is yet to be shown (although we agree it is likely).…”

Economic Burden and Health Care Access for Patients With Inflammatory Bowel Diseases in China: Web-Based Survey Study

“…The total financial burden of IBD in the United States was estimated to be US $14.6 billion to US $31.6 billion in 2014 [ 6 ]; however, recent data have indicated that the total costs may far exceed these earlier estimates [ 7 ]. In Canada, wherein the prevalence of IBD is one of the highest in the world, the economic cost for IBD was conservatively estimated to be over US $0.9 billion in 2018 [ 8 ]. In Europe, 2.5-3 million people have been estimated to be affected with IBD with a direct health care cost of 4.6-5.6 billion Euros/year [ 9 ].…”

Establishment and evaluation of specific antibiotic-induced Inflammatory bowel disease (IBD) model in rats

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