Economic analysis in chronic diseases is a prerequisite for planning a proper distribution of health care resources.
Dr Selwyn Odes and colleagues determined the cost of inflammatory bowel disease (IBD), a lifetime illness with considerable morbidity.
The investigative team studied 1321 patients from an inception cohort in 8 European countries and Israel over 10 years.
Data on consumption of resources were obtained retrospectively.
The investigators calculated the cost of health care from the use of resources and their median prices.
|Hospitalizations accounted for 63% of the cost in Crohn's|
Data were analyzed using regression models based on the generalized estimating equations approach.
The team found that the mean annual total expenditure on health care was 1871€ or $2399 per patient-year for inflammatory bowel disease.
The investigators noted that the annual total expenditure for ulcerative colitis was 1524€ or $1954 per patient-year.
For Crohn's disease, the cost was 2548€ or $3268 per patient-year for Crohn's disease.
The most expensive resources were medical and surgical hospitalizations.
The team found that together, the use of these resources accounted for 63% of the cost in Crohn's disease and 45% in ulcerative colitis.
Total and hospitalization costs were much higher in the first year after diagnosis than in subsequent years.
The team noted that differences in medical and surgical hospitalizations were the primary cause of substantial intercountry variations of cost.
The mean cost of health care was 3705€ or $4751 per patient-year in Denmark and 888€ or $1139 per patient-year in Norway.
The outlay for mesalamine, a costly medication with extensive use, was greater than for all other drugs combined.
The investigators observed that patient age at diagnosis and sex did not affect costs.
Dr Odes' team concludes, “In this multinational, population-based, time-dependent characterization of the health care cost of IBD, increased expenditure was driven largely by country, diagnosis, hospitalization, and follow-up year.”