Costs and resource utilization for diagnosis and treatment during the initial year in a european inflammatory bowel disease inception cohort: An ECCO-EpiCom study

Johan Burisch, Hillel Vardi, Natalia Pedersen, Marko Brinar, Silvja Cukovic-Cavka, Ioannis Kaimakliotis, Dana Duricova, Martin Bortlik, Olga Shonová, Ida Vind, Søren Avnstrøm, Niels Thorsgaard, Susanne Krabbe, Vibeke Andersen, Jens F. Dahlerup, Jens Kjeldsen, Riina Salupere, Jóngero Olsen, Kári R. Nielsen, Pia ManninenPekka Collin, Konstantinnos H. Katsanos, Epameinondas V. Tsianos, Karin Ladefoged, Laszlo Lakatos, Yvonne Bailey, Colm O'Morain, Doron Schwartz, Guido Lupinacci, Angelo De Padova, Laimas Jonaitis, Limas Kupcinskas, Svetlana Turcan, Louisa Barros, Fernando Magro, Daniela Lazar, Adrian Goldis, Inna Nikulina, Elena Belousova, Alberto Fernandez, Juan R. Pineda, Sven Almer, Jonas Halfvarson, Her Hsin Tsai, Shaji Sebastian, Michael Friger, Dan Greenberg, Peter L. Lakatos, Ebbe Langholz, Selwyn Odes, Pia Munkholm

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Abstract

Background: No direct comparison of health care cost in patients with inflammatory bowel disease across the European continent exists. The aim of this study was to assess the costs of investigations and treatment for diagnostics and during the first year after diagnosis in Europe. Methods: The EpiCom cohort is a prospective population-based inception cohort of unselected inflammatory bowel disease patients from 31 Western and Eastern European centers. Patients were followed every third month from diagnosis, and clinical data regarding treatment and investigations were collected. Costs were calculated in euros (€) using the Danish Health Costs Register. Results: One thousand three hundred sixty-seven patients were followed, 710 with ulcerative colitis, 509 with Crohn's disease, and 148 with inflammatory bowel disease unclassified. Total expenditure for the cohort was €5,408,174 (investigations: €2,042,990 [38%], surgery: €1,427,648 [26%], biologicals: €781,089 [14%], and standard treatment: €1,156,520 [22%)]). Mean crude expenditure per patient in Western Europe (Eastern Europe) with Crohn's disease: investigations €1803 (€2160) (P = 0.44), surgery €11,489 (€13,973) (P = 0.14), standard treatment €1027 (€824) (P = 0.51), and biologicals €7376 (€8307) (P = 0.31). Mean crude expenditure per patient in Western Europe (Eastern Europe) with ulcerative colitis: investigations €1189 (€1518) (P < 0.01), surgery €18,414 (€12,395) (P = 0.18), standard treatment €896 (€798) (P < 0.05), and biologicals €5681 (€72) (P = 0.51). Conclusions: In this population-based unselected cohort, costs during the first year of disease were mainly incurred by investigative procedures and surgeries. However, biologicals accounted for >15% of costs. Long-term follow-up of the cohort is needed to assess the cost-effectiveness of biological agents.

Original languageEnglish
Pages (from-to)121-131
Number of pages11
JournalInflammatory bowel diseases
Volume21
Issue number1
DOIs
Publication statusPublished - Jan 1 2015

Keywords

  • Crohn's disease
  • Economics of IBD therapies
  • Epidemiology
  • Outcomes research
  • Ulcerative colitis

ASJC Scopus subject areas

  • Immunology and Allergy
  • Gastroenterology

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    Burisch, J., Vardi, H., Pedersen, N., Brinar, M., Cukovic-Cavka, S., Kaimakliotis, I., Duricova, D., Bortlik, M., Shonová, O., Vind, I., Avnstrøm, S., Thorsgaard, N., Krabbe, S., Andersen, V., Dahlerup, J. F., Kjeldsen, J., Salupere, R., Olsen, J., Nielsen, K. R., ... Munkholm, P. (2015). Costs and resource utilization for diagnosis and treatment during the initial year in a european inflammatory bowel disease inception cohort: An ECCO-EpiCom study. Inflammatory bowel diseases, 21(1), 121-131. https://doi.org/10.1097/MIB.0000000000000250