1. Health-care costs of inflammatory bowel disease in a pan-European, community-based, inception cohort during 5 years of follow-up: a population-based study
- Author
-
Montserrat Figueira, K R Nielsen, Luciano Sanroman, Ebbe Langholz, Hillel Vardi, Selwyn Odes, Daniela Lazăr, Fernando Magro, Laszlo Lakatos, Riina Salupere, I. Kaimakliotis, Carlos Gonzalez-Portela, Juan-Ramon Pineda, Emma Whitehead, Michael Friger, Niels Thorsgaard, Katherine Ashton, Petra Weimers, Irena Valantiene, Hendrika Adriana Linda Kievit, Vibeke Andersen, Jesús Martínez-Cadilla, Pia Munkholm, Konstantinos H. Katsanos, Peterne Demenyi, Jóngerð Maria Miné Midjord, Karen Kudsk, Adrian Goldis, Jose-Ignacio Rodriguez-Prada, Renata D'Incà, Ruta Kucinskiene, Gediminas Kiudelis, Dimitrios Politis, Pekka Collin, Jens Kjeldsen, M. Giannotta, David Martinez Ares, Corinne Gower-Rousseau, Milan Lukas, Laimas Virginijus Jonaitis, Amalia Carmona, Clays Aalykke, Carl Eriksson, Juozas Kupcinskas, Szabina Nemethne Kramli, Katrine Carlsen, Ulla-Britt Widen, Svetlana Turcan, Martin Bortlik, Birgitte Blichfeldt, Luísa Castro, Zeljko Krznaric, Dana Duricova, Natalia Pedersen, Karina Winther Andersen, Zsuzsanna Vegh, Limas Kupčinskas, Romanas Zykus, Johan Burisch, Alessandro Sartini, Pierre Ellul, Santos Pereira, Vicent Hernandez, V Domislović, Jonas Halfvarson, G. Girardin, Naila Arebi, A. Santini, Alberto Fernandez, Shaji Sebastian, Sally Myers, Doron Schwartz, D. Valpiani, Luísa Barros, Alexandros Skamnelos, Dorte Marker, Stefania Chetcuti Zammit, Silvija Čuković-Čavka, Mathurin Fumery, Jens Frederik Dahlerup, Peter L. Lakatos, Pia Oksanen, Inna Nikulina, Nikša Turk, Anastasia Nicolaou, Dimitrios K. Christodoulou, Elena Belousova, Ida Vind, Olga Shonová, Giualia Dal Piaz, Registre EPIMAD, CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Amiens-Picardie-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), IBD clinical and research centre, ISCARE, Prague, Czech Republic, Service Psychiatrie de l'Enfant et de l'Adolescent, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Robert Debré, School of Medicine, University of Zagreb, Hull and East Yorkshire Eye Hospital, Madeira Interactive Technologies Institute (M-ITI), Hospital de São João [Porto], Timisoara Hospital [Timisoara, Romania], Dept of Medicine, Div of Gastroenterology, Örebro University Hospital [Örebro, Sweden], Macquarie University, University of Copenhagen = Københavns Universitet (UCPH), Lithuanian University of health Sciences [Kaunas], CHU Amiens-Picardie, Périnatalité et Risques Toxiques - UMR INERIS_I 1 (PERITOX), Institut National de l'Environnement Industriel et des Risques (INERIS)-Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, Service d'Epidémiologie et de Santé Publique [Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Institute for Translational Research in Inflammation - U 1286 (INFINITE (Ex-Liric)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), and Semmelweis University [Budapest]
- Subjects
Adult ,Male ,medicine.medical_specialty ,[SDV]Life Sciences [q-bio] ,Disease ,Inflammatory bowel disease ,03 medical and health sciences ,Indirect costs ,0302 clinical medicine ,Crohn Disease ,Internal medicine ,Health care ,medicine ,Humans ,Prospective Studies ,Prospective cohort study ,Diagnostic Techniques and Procedures ,Digestive System Surgical Procedures ,Biological Products ,Hepatology ,business.industry ,Gastroenterology ,Health Care Costs ,Middle Aged ,medicine.disease ,Ulcerative colitis ,digestive system diseases ,Europe ,Hospitalization ,030220 oncology & carcinogenesis ,Cohort ,Population study ,na ,Colitis, Ulcerative ,Female ,030211 gastroenterology & hepatology ,business ,Follow-Up Studies - Abstract
BACKGROUND: Inflammatory bowel disease (IBD) places a significant burden on health-care systems because of its chronicity and need for expensive therapies and surgery. With increasing use of biological therapies, contemporary data on IBD health-care costs are important for those responsible for allocating resources in Europe. To our knowledge, no prospective long-term analysis of the health-care costs of patients with IBD in the era of biologicals has been done in Europe. We aimed to investigate cost profiles of a pan-European, community-based inception cohort during 5 years of follow-up.METHODS: The Epi-IBD cohort is a community-based, prospective inception cohort of unselected patients with IBD diagnosed in 2010 at centres in 20 European countries plus Israel. Incident patients who were diagnosed with IBD according to the Copenhagen Diagnostic Criteria between Jan 1, and Dec 31, 2010, and were aged 15 years or older the time of diagnosis were prospectively included. Data on clinical characteristics and direct costs (investigations and outpatient visits, blood tests, treatments, hospitalisations, and surgeries) were collected prospectively using electronic case-report forms. Patient-level costs incorporated procedures leading to the initial diagnosis of IBD and costs of IBD management during the 5-year follow-up period. Costs incurred by comorbidities and unrelated to IBD were excluded. We grouped direct costs into the following five categories: investigations (including outpatient visits and blood tests), conventional medical treatment, biological therapy, hospitalisation, and surgery.FINDINGS: The study population consisted of 1289 patients with IBD, with 1073 (83%) patients from western Europe and 216 (17%) from eastern Europe. 488 (38%) patients had Crohn's disease, 717 (56%) had ulcerative colitis, and 84 (6%) had IBD unclassified. The mean cost per patient-year during follow-up for patients with IBD was €2609 (SD 7389; median €446 [IQR 164-1849]). The mean cost per patient-year during follow-up was €3542 (8058; median €717 [214-3512]) for patients with Crohn's disease, €2088 (7058; median €408 [133-1161]) for patients with ulcerative colitis, and €1609 (5010; median €415 [92-1228]) for patients with IBD unclassified (pINTERPRETATION: Overall direct expenditure on health care decreased over a 5-year follow-up period. This period was characterised by increasing expenditure on biologicals and decreasing expenditure on conventional medical treatments, hospitalisations, and surgeries. In light of the expenditures associated with biological therapy, cost-effective treatment strategies are needed to reduce the economic burden of inflammatory bowel disease.FUNDING: Kirsten og Freddy Johansens Fond and Nordsjællands Hospital Forskningsråd.
- Published
- 2020