Data regarding the health care costs of inflammatory bowel disease (IBD) in the United States are limited.
Dr Michael Kappelman and colleagues from North Carolina, USA estimated the direct costs of Crohn's disease and ulcerative colitis in the United States.
The research team described the distribution of costs among inpatient, outpatient, and pharmaceutical services, and identified sociodemographic factors influencing these costs.
The team extracted medical and pharmacy claims from an administrative database containing insurance claims from 87 health plans in 33 states, occurring between 2003 and 2004.
The research team identified cases of Crohn’s disease and ulcerative colitis using an administrative definition.
|For Crohn’s, 31% of costs were attributable to hospitalization|
For each case, we selected up to 3 non-inflammatory bowel disease controls.
Claims were classified as inpatient, outpatient, or pharmaceutical according to Current Procedural Terminology codes or National Drug Codes.
Costs were based on the paid amount of each claim.
Inflammatory bowel disease-attributable costs were estimated by subtracting costs for non-IBD patients from those for patients with IBD.
Logistic regression was used to identify the sociodemographic factors affecting these costs.
The team identified 9056 patients with Crohn’s disease and 10,364 patients with ulcerative colitis.
Mean annual costs for Crohn’s disease and ulcerative colitis were $8265 and $5066, respectively.
For Crohn’s disease, 31% of costs were attributable to hospitalization, 33% to outpatient care, and 35% to pharmaceutical claims.
The team noted that the corresponding distribution for ulcerative colitis was 38%, 35%, and 27%, respectively.
Costs were significantly higher for children younger than 20 years compared with adults, but this did not vary substantially by sex or region.
Dr Kappelman’s team comments, “We demonstrate a substantial economic burden of IBD and can be used to inform health policy.”