The cost burden of Crohn's disease and ulcerative colitis depending on biologic treatment status - a Danish
Sarah Alulis1, Kasper Vadstrup2, Jens Olsen3
1Janssen-Cilag, Bregnerødvej 133, 3460, Birkerød, Denmark. salulis@its.jnj.com.
Insights
Biologic treatment for inflammatory bowel disease (IBD) increases healthcare costs but may lower production values, especially with early intervention in Crohn's disease (CD) and ulcerative colitis (UC).
Area of Science:
- Gastroenterology
- Health Economics
- Pharmacoeconomics
Background:
- Inflammatory bowel disease (IBD), encompassing Crohn's disease (CD) and ulcerative colitis (UC), is often managed with biologic therapies.
- Patient selection for biologics involves various medical and non-medical factors.
- This study examines the economic impact of biologic treatments in IBD patients.
Purpose of the Study:
- To investigate the healthcare costs associated with biologic treatment in CD and UC patients.
- To assess the impact of biologic therapy on the production values (economic productivity) of IBD patients.
- To compare early versus delayed initiation of biologic treatment concerning costs and productivity.
Main Methods:
- A national register-based study utilizing the Danish National Patient Register (DNPR) from 2003 to 2015.
- Inclusion of patients diagnosed with CD and UC.
- Comparison of average annual healthcare costs and production values between biologic-treated and non-biologic-treated patients, and by timing of treatment initiation.
Main Results:
- 26.1% of CD patients and 10.7% of UC patients received biologic treatment during the study period.
- Higher average annual healthcare costs were observed in both CD and UC patients treated with biologics compared to those not treated.
- Early biologic initiation in CD patients was associated with lower production values pre- and post-treatment compared to later initiation. UC patients also showed reduced production values in the first year post-treatment initiation with early biologics.
Conclusions:
- Biologic treatment for CD and UC is linked to increased healthcare expenditures, primarily driven by outpatient visits and hospital admissions.
- Patients receiving biologic therapy generally exhibit lower average annual production values compared to non-biologic users.
- The timing of biologic treatment initiation may influence the long-term economic productivity of IBD patients.
Background:
Patients diagnosed with inflammatory bowel disease may be treated with biologics, depending on several medical and non-medical factors. This study investigated healthcare costs and production values of patients treated with biologics.
Methods:
This national register study included patients diagnosed with Crohn's disease (CD) and ulcerative colitis (UC) between 2003 and 2015, identified in the Danish National Patient Register (DNPR). Average annual healthcare costs and production values were compared for patients receiving biologic treatment or not, and for patients initiating biologic treatment within a year after diagnosis or at a later stage. Cost estimates and production values were based on charges, fees and average gross wages.
Results:
Twenty-six point one percent CD patients and ten point seven percent of UC patients were treated with biologics at some point in the study period. Of these, 46.4 and 45.5 % of patients initiated biologic treatment within the first year after diagnosis. CD and UC patients treated with biologics had higher average annual healthcare costs after diagnosis compared to patients not treated with biologics. CD patients receiving biologics early had lower production values both ten years before and eight years after treatment initiation, compared to patients receiving treatment later. UC patients receiving biologics early had lower average annual production values the first year after treatment initiation compared to UC patients receiving treatment later.
Conclusions:
CD and UC patients receiving biologic treatment had higher average annual healthcare costs and lower average annual production values, compared to patients not receiving biologic treatment. The main healthcare costs drivers were outpatient visit costs and admission costs.
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