Cost of illness of inflammatory bowel disease in the UK: a single centre retrospective study

Abstract

Background and aims: The potentially high costs of care associated with inflammatory bowel disease (IBD) are recognised but we have little knowledge of the scale, profile, or determinants of these costs in the UK. This study aimed to describe costs of illness for a group of IBD patients and determine factors associated with increased healthcare costs. Setting: A university hospital serving a target population of approximately 330 000. Patients and methods: A six month cohort of IBD patients receiving any form of secondary care was identified, comprising 307 cases of ulcerative (or indeterminate) colitis and 172 cases of Crohn's disease. Demographic and clinical data were abstracted from clinical records and individual resource use was itemised for all attributable costs (including extraintestinal manifestations). Item costs were derived from national and local sources. Cost data were expressed as mean six month costs per patient (with 95% confidence interval (CI)) obtained using non-parametric bootstrapping. Determinants of cost were analysed using generalised linear regression modelling. A postal survey of patients was undertaken to examine indirect costs, out of pocket expenses, and primary care visits. Results: Inpatient services (medical and/or surgical) were required by 67 patients (14%) but accounted for 49% of total secondary care costs. Drug costs accounted for less than a quarter of total costs. Individual patient costs ranged from £73 to £33 254 per six months. Mean (95% CI) six month costs per patient were £1256 (£988, £1721) for colitis and £1652 (£1221, £2239) for Crohn's disease. Hospitalisation, disease severity grade, and disease extent correlated positively with cost of illness but costs were independent of age or sex. Compared with quiescent cases of IBD, disease relapse was associated with a 2-3-fold increase in costs for non-hospitalised cases and a 20-fold increase in costs for hospitalised cases. Survey data suggested average six month costs were ,£30 per patient for primary care visits (both diseases) and median loss of earnings were £239 for colitis and £299 for Crohn's disease. Conclusions: This study represents the first detailed characterisation of the scale and determinants of costs of illness for IBD in a British hospital. Hospitalisation affected a minority of sufferers but accounted for half of the total direct costs falling on the healthcare system.

Mycobacterium avium subsp. paratuberculosis in powdered infant milk: paratuberculosis in cattle - the public health problem to be solved

“…Crohn's disease is also very important for both the people suffering from the severe chronical illness with all its painful and difficult attributes and for the huge expenditure for treatment and additional costs (Juan et al, 2003;Bassi et al, 2004;Ebinger et al, 2004). Information already available is sufficient to accept the possibility of a risk for consumers resulting not only from the viable MAP, but also from inactive or dead cells and even from their structural components.…”

A Model-Based Economic Evaluation of Biologic and Non-Biologic Options for the Treatment of Adults with Moderately-to-Severely Active Ulcerative Colitis after the Failure of Conventional Therapy

“…The burden of UC for the NHS is substantial, particularly in patients with poor disease control. Compared with quiescent IBD, disease relapse is associated with an estimated 2-3-fold increase in costs for non-hospitalised cases and a 20-fold increase in costs for hospitalised cases [3]. Approximately 80% patients with UC have mild-to-moderate disease, and approximately 20% have severe disease.…”

Administrative Claims Analysis of All-Cause Annual Costs of Care and Resource Utilization by Age Category for Ulcerative Colitis Patients

“…24 Another study found that, over a 10-year period, the cost of hospitalization was 45% of the total cost of UC treatment. 25 Also, data from the Healthcare Cost and Utilization Project (HCUP) showed that the mean length of stay and the mean cost of hospitalization for inflammatory bowel diseases, including UC, were higher than for all conditions combined, using pooled data (6.1 days vs. 4.6 days and $9,200 vs. $7,700, respectively).…”