TY - JOUR

T1 - Costs and Resource Utilization for Diagnosis and Treatment During the Initial Year in a European Inflammatory Bowel Disease Inception Cohort

T2 - An ECCO-EpiCom Study

AU - Burisch, J.

AU - Vardi, Hillel

AU - Pedersen, Natalia

AU - Brinar, Marko

AU - Cukovic-Cavka, Silvja

AU - Kaimakliotis, Ioannis

AU - Duricova, Dana

AU - Bortlik, Martin

AU - Shonová, Olga

AU - Vind, Ida

AU - Avnstrøm, Søren

AU - Thorsgaard, Niels

AU - Krabbe, Susanne

AU - Andersen, Vibeke

AU - Dahlerup, Jens F

AU - Kjeldsen, Jens

AU - Salupere, Riina

AU - Olsen, Jónger

AU - Nielsen, Kári R

AU - Manninen, Pia

AU - Collin, Pekka

AU - Katsanos, Konstantinnos H

AU - Tsianos, Epameinondas V

AU - Ladefoged, Karin

AU - Lakatos, Laszlo

AU - Bailey, Yvonne

AU - OʼMorain, Colm

AU - Schwartz, Doron

AU - Lupinacci, Guido

AU - De Padova, Angelo

AU - Jonaitis, Laimas

AU - Kupcinskas, Limas

AU - Turcan, Svetlana

AU - Barros, Louisa

AU - Magro, Fernando

AU - Lazar, Daniela

AU - Goldis, Adrian

AU - Nikulina, Inna

AU - Belousova, Elena

AU - Fernandez, Alberto

AU - Pineda, Juan R

AU - Almer, Sven

AU - Halfvarson, Jonas

AU - Tsai, Her-Hsin

AU - Sebastian, Shaji

AU - Friger, Michael

AU - Greenberg, Dan

AU - Lakatos, Peter L

AU - Langholz, Ebbe

AU - Munkholm, Pia

AU - EpiCom Group

PY - 2015/1

Y1 - 2015/1

N2 - 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.

AB - 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.

KW - Adolescent

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Cohort Studies

KW - Europe

KW - Female

KW - Follow-Up Studies

KW - Health Care Costs

KW - Health Resources

KW - Humans

KW - Inflammatory Bowel Diseases

KW - Male

KW - Middle Aged

KW - Prognosis

KW - Surveys and Questionnaires

KW - Time Factors

KW - Young Adult

U2 - 10.1097/MIB.0000000000000250

DO - 10.1097/MIB.0000000000000250

M3 - Journal article

C2 - 25437816

VL - 21

SP - 121

EP - 131

JO - Inflammatory Bowel Diseases

JF - Inflammatory Bowel Diseases

SN - 1078-0998

IS - 1

ER -