Indirect costs associated with ulcerative colitis: a systematic literature review of real-world data

Constantin, Joëlle; Atanasov, Petar; Wirth, Daniel; Borsi, András

doi:10.1186/s12876-019-1095-9

Cited by 16 publications

(10 citation statements)

References 31 publications

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“…Most economic evaluations focus on direct cost drivers, such as medication, hospitalizations, and surgery. However, given the disease's epidemiological characteristics and age distribution, indirect costs contribute substantially to high overall total disease costs 17 .…”

Section: Discussionmentioning

confidence: 99%

Health-related quality of life, work productivity and costs related to patients with inflammatory bowel disease in Austria

Walter

Hausberger

Groß³

et al. 2020

Journal of Medical Economics

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Objective: Inflammatory-Bowel-Disease (IBD) is a lifelong illness with significant impact on health-related quality of life (HRQoL). The disease-burden causes work productivity impairment, such as sick-leave and restriction of leisure time activities. From a societal perspective, productivity loss often contributes significantly to the total costs. The aim of the study is to analyze the impact of disease-burden on work productivity, daily activities, and HRQoL. Methods: We performed a survey among Austrian patients with IBD to assess general questions about demography and disease pattern, impaired work productivity and reduced daily activities using the Work Productivity and Activity Impairment questionnaire and HRQoL utilizing the Short Inflammatory Bowel Disease Questionnaire (SIBDQ). Associations were assessed employing linear regressions. The questionnaire was circulated by the Austrian Crohn's Disease/Ulcerative Colitis Association. Results: In total, 510 patients with median age of 40 years completed the questionnaire. Patients had a median disease-duration of 9 years, 46% were treated with biologics and 64% were employed. The median SIBDQ score was 45 (16-69). Patients in self-assessed remission (n ¼ 319) and relapse (n ¼ 96) differed by 18 points on the SIBDQ score (p value < 0.0001). Mean work productivity reduction amounted to 7 h 17 min (95% CI 6:05-8:29) during the last 7 days. Work absenteeism accounted for 4 h 28 min (95% CI 3:25-5:31) and reduced productivity at the workplace (presenteeism) for 2 h 49 min (95% CI 2:31-3:07). During a relapse, 12 h 9 min were lost (p value < 0.0001). Productivity reduction correlated with HRQoL (r ¼ 0.3964). In total, 143 eper patient per week (95% CI 119-167) were lost (7,411 eper year). On average, patients lost 4 h (95% CI 3:44-4:16) of unpaid daily activities; 3 h 17 min the employed subgroup and 5 h 19 min the not employed. Conclusion: IBD leads to a substantial burden of disease, which is associated with indirect costs for society related to work ability reduction. HRQoL significantly influences loss of work productivity. Improving HRQoL should be a key factor to reduce disease burden and societal costs.

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Section: Discussionmentioning

confidence: 99%

Health-related quality of life, work productivity and costs related to patients with inflammatory bowel disease in Austria

Walter

Hausberger

Groß³

et al. 2020

Journal of Medical Economics

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“… 13 , 14 Since then, many new treatment modalities have become available, and numerous studies on the costs of IBD have been published. Reviews on the indirect costs of IBD and costs for the paediatric population have been published since, 15 , 16 , 17 , 18 , 19 but no comprehensive review on the cost of illness of IBD has been carried out.…”

Section: Introductionmentioning

confidence: 99%

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

Linschoten

Visser

Niehot³

et al. 2021

Aliment Pharmacol Ther

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Summary Background Knowledge of the cost of illness of inflammatory bowel disease (IBD) is essential for health policy makers worldwide. Aim To assess the cost of illness of IBD from the societal perspective taking into account time trends and geographical differences. Methods A systematic review of all population‐based studies on cost of illness of IBD published in Embase, Medline, Web of Science and Google Scholar. Methodology of included studies was assessed and costs were adjusted to 2018 US dollars. Results Study methodologies differed considerably, with large differences in perspective, valuation method and population. For prevalent Crohn's disease (CD) cases in the last ten years annual healthcare costs were in Asia $4417 (range $1230‐$31 161); Europe $12 439 ($7694‐$15 807) and North America $17 495 ($14 454‐$20 535). For ulcerative colitis (UC), these were $1606 ($309‐$14 572), $7224 ($3228‐$9779) and $13 559 ($13 559‐$13 559). The main cost driver was medication, the cost of which increased considerably between 1985 and 2018, while outpatient and inpatient costs remained stable. IBD had a negative impact on work productivity. Annual costs of absenteeism for CD and UC were in Asia (with presenteeism) $5638 ($5638‐$5638) and $4828 ($4828‐$4828); Europe $2660 ($641‐$5277) and $2394 ($651‐$5992); North America $752 ($307‐$1303) and $1443 ($85‐$2350). Conclusion IBD societal cost of illness is increasing, driven by growing costs of medication, and varies considerably between continents. While biologic therapy was expected to decrease inpatient costs by reducing hospitalisations and surgery, these costs have not declined.

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“…UC has a significant impact on quality of life, work productivity, and out-of-pocket expenses, and has an important and significant role in disease burden [ 51 ]. The indirect cost was not incorporated in the analysis; a systematic literature analysis reported 35% of total UC costs were associated with indirect costs [ 52 ]. Alternatively, injection or intravenous infusion therapies exposed patients to potential out-of-pocket expenses (i.e., transportation) and led to a greater chance of infection or discomfort [ 53 ].…”

Section: Discussionmentioning

confidence: 99%

Cost Effectiveness of Tofacitinib for the Treatment of Moderate to Severe Active Ulcerative Colitis in Colombia

Parada

Baños

Amador³

et al. 2022

PharmacoEconomics Open

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Objective The aim of this study was to evaluate the cost effectiveness of tofacitinib versus other treatment options currently available in Colombia in naïve to biologics (first-line) and exposed to biologics (second-line) patients with moderate to severe active ulcerative colitis (UC). Methods A Markov model was constructed with 8-week cycles, simulating a cohort of patients in a 5-year time horizon. The health states included remission, treatment response, active UC, and colectomy. The transition probabilities for the induction and maintenance phase were obtained from a network meta-analysis, and effectiveness was measured using quality-adjusted life-years (QALYs). Unit costs were derived from official national sources. Results For first line, the incremental cost-effectiveness ratio (ICER) per QALY was $883 for tofacitinib and $3619 for infliximab, compared with adalimumab. Sensitivity analysis showed that tofacitinib is cost effective in 45% of the iterations, adalimumab in 5%, and infliximab in 50%. Meanwhile, the ICER of adalimumab was $14,927 compared with tofacitinib in second-line treatment. In the sensitivity analysis, tofacitinib was cost effective in 64% of the iterations, followed by adalimumab in 36%. Infliximab and golimumab were not included due to data limitations in the network meta-analysis of second-line treatment. Conclusion The analysis suggests that in Colombia, treatment with tofacitinib for patients with moderate-to-severe UC is a cost-effective option in both lines compared with other treatment options. Supplementary Information The online version contains supplementary material available at 10.1007/s41669-022-00360-4.

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Indirect costs associated with ulcerative colitis: a systematic literature review of real-world data

Cited by 16 publications

References 31 publications

Health-related quality of life, work productivity and costs related to patients with inflammatory bowel disease in Austria

Health-related quality of life, work productivity and costs related to patients with inflammatory bowel disease in Austria

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

Cost Effectiveness of Tofacitinib for the Treatment of Moderate to Severe Active Ulcerative Colitis in Colombia

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