Economic Impact of Daily Bowel Management Regimens

Area of Science:

• Pediatric Gastroenterology
• Health Economics
• Clinical Outcomes

Background:

• Chronic constipation and fecal incontinence significantly impact patients with anorectal malformations, Hirschsprung's disease, idiopathic constipation, and spina bifida/spinal cord injuries.
• Effective bowel management regimens are crucial for patient independence, reducing reliance on diapers and managing stool accidents.
• Over-the-counter bowel management medications (laxatives, enemas) are often not covered by insurance, posing a financial challenge for families.

Purpose of the Study:

• To review the costs associated with various bowel management regimens.
• To analyze the economic impact of these treatments on affected families.
• To provide data supporting advocacy for improved insurance coverage.

Main Methods:

• Retrospective review of 430 patients undergoing bowel management from January 2016 to September 2023.
• Analysis of medication costs (laxatives, enemas) and comparison with costs of diapers/incontinence briefs.
• Calculation of mean annual family income based on patient zip codes.

Main Results:

• Annual costs for laxatives varied from $15.70 to $2938.10; enemas ranged from $29.20 to $4380.00.
• Costs for diapers/incontinence briefs ranged from $131.40 to $4343.50 annually.
• Median annual family incomes spanned $32,192 to $225,119 across 41 states.

Conclusions:

• Significant financial burden exists for families managing chronic bowel conditions.
• Counseling families on medication costs is vital for treatment adherence.
• Data supports advocating for enhanced insurance coverage for essential bowel management medications.