Burden of Crohn's disease in the United States: long-term healthcare and work-loss related costs. (2nd October 2020)

• Record Type: Journal Article
• Authors: Manceur, Ameur M.; Ding, Zhijie; Muser, Erik; Obando, Camilo; Voelker, Jennifer; Pilon, Dominic; Kinkead, Frederic; Lafeuille, Marie-Hélène; Lefebvre, Patrick
• Is Part Of: Journal of medical economics. Volume 23:Number 10(2020)
• Page Start: 1092
• Page End: 1101
• Publication Date: 2020-10-02
• Subjects: Crohn's disease -- costs -- real-world data -- chronic burden -- inflammatory bowel disease -- work loss; I10 -- I11; Medical care -- Cost control -- Periodicals; Medical economics -- Periodicals; 362.10941
• DOI: 10.1080/13696998.2020.1789649
• Languages: English
• ISSNs: 1369-6998

Abstract

Abstract: Aims: To quantify the long-term direct and indirect costs among patients with Crohn's disease (CD) and specific subgroups of these patients in the United States from the private payer's perspective. Materials and methods: This retrospective study used the OptumHealth Care Solutions, Inc database (01 January 1999–31 March 2017) to match (1:5) adult patients with ≥2 claims for CD to patients without inflammatory bowel disease (IBD). Patterns observed during follow-up (i.e. biologics, opioids, or steroids; CD-related surgery; moderate-to-severe disease; and comorbidities) were used to identify CD subgroups. Comparisons of healthcare resource utilization, work loss days, and direct and indirect work loss-related costs were made between matched cohorts. Descriptive analyses of costs were conducted within each CD subgroup. Results: There were 6, 715 and 33, 575 patients in the CD and non-IBD cohorts, respectively. The direct burden was significantly higher in the CD cohort compared to the non-IBD cohort, with 0.34 inpatient admissions per patient per year (PPPY) versus 0.12 (217% increase; p < .001), and $24, 500 direct healthcare costs PPPY versus $7, 037 ($17, 463 increase; p < .001). The trend was similar for the indirect burden, with work loss–related costs PPPY of $5, 490 in the CD cohort versus $3, 322 in the non-IBD cohort ($2, 168 increase; p < .001). The burden was numerically higher in the CD subgroups, with direct healthcare costs reaching $101, 013 PPPY in the surgery subgroup. Limitations: Severity of CD was determined based on claims-based algorithms due to the lack of access to medical files. Absenteeism was imputed based on claims data, and presenteeism was not assessed. Conclusions: The direct healthcare and indirect work loss–related costs of patients with CD was significantly higher compared to patients without IBD over an average follow-up of 5 years.