Abstract
Introduction: Up-to-date estimation of healthcare costs in Ulcerative Colitis (UC) and Crohn's Disease (CD) patients is crucial to inform budgeting and resource allocation decisions. The increasing use of biologic therapies in these diseases has rendered previous cost studies with standard therapy obsolete. We sought to determine healthcare costs in real-world UC and CD patients managed in a specialized facility in a tertiary referral center.
Methods: Data-bases of patients enrolled in an ongoing socio-economic study were mined to determine health resource utilization during the years 2012, 2013 and 2014. This included out-patient consultations, emergency department visits, hospitalizations, investigations (imaging, endoscopy), pharmacological treatments and surgical procedures. Prices were obtained from the Ministry of Health Tariff for Health Services (12/2014). Data express costs related to UC and CD, excluding co-morbidities, and are expressed as US$ (2014).
Results: There were 238 UC patients (M:F ratio 1.01, mean age 50.6±16.7 y) and 237 CD patients (M:F ratio 0.94, mean age 40.2±15.9 y). The mean [median] healthcare cost/patient for UC was: 2012, $1,582 [$755]; 2013, $1,799 [$712]; 2014 $1,696 [$544]. The mean [median] healthcare cost/patient for CD was: 2012, $3,909 [$1,192]; 2013, $4,421 [$1,080]; 2014, $4,462 [$1,108]. Over the three-year time period, the major cost drivers in UC were diagnostic procedures 34.1%, biologic medication 24.0%, standard medication 16.6%, consultations 14.2%, hospitalization 5.8%, surgery 5.2%. In CD, the cost drivers were biologic medication 56.8%, diagnostic procedures 11.8% surgery 11.4%, consultations 7.8%, hospitalization 7.0%, standard medication 5.0%. The use of biologic medication increased progressively in both diseases over the 3 year period, with mean/patient cost of $406 for UC and $2443 for CD, ratio UC to CD = 0.17. There was a progressive decrease in the cost of hospitalizations, 77% in UC and 70% in CD, but there was no decrease noted in surgical costs in both diseases.
Conclusion: CD patients engender much higher healthcare costs that those with UC. Expensive biologic medication has become the major cost driver in both CD and UC in the current era. Hospitalization costs have been reduced, but not expenses engendered by surgery. Overall, the cost of treating UC and CD patients in this biological area has increased.
Methods: Data-bases of patients enrolled in an ongoing socio-economic study were mined to determine health resource utilization during the years 2012, 2013 and 2014. This included out-patient consultations, emergency department visits, hospitalizations, investigations (imaging, endoscopy), pharmacological treatments and surgical procedures. Prices were obtained from the Ministry of Health Tariff for Health Services (12/2014). Data express costs related to UC and CD, excluding co-morbidities, and are expressed as US$ (2014).
Results: There were 238 UC patients (M:F ratio 1.01, mean age 50.6±16.7 y) and 237 CD patients (M:F ratio 0.94, mean age 40.2±15.9 y). The mean [median] healthcare cost/patient for UC was: 2012, $1,582 [$755]; 2013, $1,799 [$712]; 2014 $1,696 [$544]. The mean [median] healthcare cost/patient for CD was: 2012, $3,909 [$1,192]; 2013, $4,421 [$1,080]; 2014, $4,462 [$1,108]. Over the three-year time period, the major cost drivers in UC were diagnostic procedures 34.1%, biologic medication 24.0%, standard medication 16.6%, consultations 14.2%, hospitalization 5.8%, surgery 5.2%. In CD, the cost drivers were biologic medication 56.8%, diagnostic procedures 11.8% surgery 11.4%, consultations 7.8%, hospitalization 7.0%, standard medication 5.0%. The use of biologic medication increased progressively in both diseases over the 3 year period, with mean/patient cost of $406 for UC and $2443 for CD, ratio UC to CD = 0.17. There was a progressive decrease in the cost of hospitalizations, 77% in UC and 70% in CD, but there was no decrease noted in surgical costs in both diseases.
Conclusion: CD patients engender much higher healthcare costs that those with UC. Expensive biologic medication has become the major cost driver in both CD and UC in the current era. Hospitalization costs have been reduced, but not expenses engendered by surgery. Overall, the cost of treating UC and CD patients in this biological area has increased.
Original language | English GB |
---|---|
Pages (from-to) | S804-S804 |
Journal | American Journal of Gastroenterology |
Volume | 110 |
State | Published - Oct 2015 |