Work-Related Productivity Loss and Associated Indirect Costs in Patients With Crohn’s Disease or Ulcerative Colitis in the United States

Abstract

Background Inflammatory Bowel Disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), affects an estimated 1.6 million US adults, and results in humanistic and economic burden even amongst mild patients, which grows with increasing disease activity. Methods Gastroenterologists and their IBD patients provided real-world data via US IBD Disease Specific Programmes™ 2014–2018. Patients with physician- and patient-reported data completing a Work Productivity and Activity Impairment questionnaire were categorized by disease activity, defined using Crohn’s Disease Activity Index (CD) and partial Mayo scores (UC) respectively. Associations of disease activity with patient-reported productivity and indirect costs were assessed. Results The analyses included 281 patients with CD and 282 patients with UC. Mean ages were 40.0 years and 40.5 years, and mean disease durations 7.1 years and 5.4 years, for CD and UC, respectively. In CD, absenteeism (0.95–14.6%), presenteeism (11.7–44.9%), and overall work impairment (12.4–51.0%) increased with increasing disease activity (all p<0.0001). In UC, absenteeism (0.6–11.9%), presenteeism (7.1–37.1%), and overall work impairment (7.5–41.9%) increased with increasing disease activity (all p<0.0001). Annual indirect costs due to total work impairment increased with increasing disease activity (all p<0.0001), from $7,169/patient/year (remission) to $29,524/patient/year (moderately-to-severely active disease) in CD and $4,348/patient/year (remission) to $24,283/patient/year (moderately-to-severely active disease) in UC. Conclusions CD and UC patients experienced increased absenteeism, presenteeism, and overall work impairment with increasing disease activity, resulting in higher indirect costs. Treatments significantly reducing IBD disease activity could provide meaningful improvements in work productivity and associated costs.

Savings in social expenditures for work incapacity in patients with inflammatory bowel disease depend on access to innovative therapies in Poland

“…Canadian authors calculated that among the approximately 30% of the IBD population with the highest burden of disease, the indirect costs of absenteeism and presenteeism account for approximately 75% of the total IBD-related costs [14]. Work disability affects up to a quarter of IBD patients, but until recently there have been no studies assessing time trends in the disability certificates or the effect of new therapies in this context [15][16][17].…”

Bridging the gap: Unveiling the crisis of physical inactivity in inflammatory bowel diseases

“…The psychological impact is exacerbated by symptoms such as pain and fatigue, resulting in a negative cycle that affects both mental and physical health. Depression in these patients may be further compounded by the social stigma and isolation associated with the disease[ 19 , 20 ]. Stress and anxiety can also exacerbate IBD symptoms, creating a complex interplay between psychological state and disease activity[ 21 ].…”

Barriers to optimizing inflammatory bowel disease care in the United States

“…They are also quite costly with yearly estimates of $4348–$7169 in remission to $24,283–$29,524 with moderate-to-severe activity for UC and CD, respectively. 56 As an illustration, assuming a patient is diagnosed with UC at age 24 with one initial year of disease activity at diagnosis followed by remission to age 65, this would sum to a total cost of nearly $200,000 not factoring in lost earned interest.…”