Health care costs and their predictors of inflammatory bowel diseases in Germany

Abstract

This is the first study to calculate costs due to CD and UC from the perspective of the SHI in Germany and to identify cost-driving factors. It confirms a high economic burden of IBD to payers and society.

The burden of inflammatory bowel disease on health care utilization and quality of life

“…Although there is evidence that Crohn's disease generates more health care use than ulcerative colitis [5,7,22], no such differences were found in our study. The IBD patients reported significantly more often that they had visited a physician during the previous year due to gastrointestinal reasons than did patients with IBS.…”

“…Studies from North America and some European countries have shown that IBD patients use more health services when compared with the background population [10][11][12]. IBDs being fluctuating in severity, a minority of the patients incur the majority of the costs [7,13,14]. There is some indication that IBD also affects work productivity; IBD has adverse effects on the whole employment career [11] and social functions such as housework and hobbies [13].…”

“…The direct costs include inpatient and outpatient care, surgery, diagnostic and followup procedures and laboratory tests, and medication. The indirect costs include lower productivity such as sick leave, unemployment, and disability [5][6][7]. IBD is related to significant morbidity, work loss, and impaired quality of life but has little effect on mortality, thus causing a high economic burden to the patient and the society [5,8,9].…”

Factors That Predict High Health Care Utilization and Costs for Patients With Inflammatory Bowel Diseases

“…3–5 It has been reported that the top 10% of patients with highest charges account for 50% of the total cost of IBD care. 6 Therefore, it is important to identify these high-risk patients and intervene to best prevent complications and improve quality of life.…”

Aktualisierte S3-Leitlinie – „Diagnostik und Therapie des Morbus Crohn“ 2014

“…Ein erhöhtes Risiko für Komplikationen der immunsuppressiven Therapie besteht insbesondere bei langdauernder Steroideinnahme, bei älteren Patienten und bei kombinierter Immunsuppression [242,244,394,395]. Inwieweit Medikamentenkosten, die bei den Anti-TNF-α-Antikörpern deutlich höher als bei Azathioprin liegen, einen wesentlichen Einfluss auf die Therapieentscheidung haben sollten, ist zu diskutieren [396]. Darüber hinaus gibt es Daten, dass bei bestimmungsgemäßem Gebrauch der Einsatz von Anti-TNF-α-Antikör-pern kosteneffizient sein kann [397].…”