The economic impact of irritable bowel syndrome in a managed care setting

To compare the healthcare resource consumption of patients who have irritable bowel syndrome (IBS) with an age-, gender-, and comorbidity-matched cohort of patients without IBS from a managed care perspective.

Retrospective cohort analysis. Data were obtained electronically through the Henry Ford Health System corporate data warehouse. Patients with IBS were eligible if they had at least one primary diagnosis of irritable colon (ICD-9-CM 564.1). The control cohort was identified from an age, gender, and comorbidity population-matched (5:1) sample. The index date for the IBS and control cohorts was defined as the first initial diagnosis and first clinical encounter in 1998, respectively. The charges per patient by resource use type were collected for the 12 months before and after the index date.

A total of 501 patients with IBS and 2505 controls fulfilled the inclusion and exclusion criteria (70% female, 58% between 40 and 65 years). The IBS cohort, before the IBS diagnosis, had significantly higher total charges (p < 0.001), drug charges (p < 0.001), and outpatient charges (p < 0.001) than the control cohort. During the postindex (postdiagnosis period), the patients with IBS had higher total charges (p < 0.006), outpatient charges (p < 0.022), and drug charges (p < 0.001) than the control population. The control cohort had higher procedure charges (p < 0.001) during both periods.

Patients with an IBS diagnosis represent a substantial cost to managed care before and after the diagnosis of IBS. Costs associated with these patients result mainly from non-IBS conditions. Further research is warranted to identify these patients earlier, and to prevent the economic burden associated with them.