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Costs and resource utilization for diagnosis and treatment during the initial year in a European inflammatory bowel disease inception cohort: an ECCO-EpiCom Study
Digestive Disease Centre, Medical Section, Herlev University Hospital, Copenhagen, Denmark.
Department of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.
Digestive Disease Centre, Medical Section, Herlev University Hospital, Copenhagen, Denmark.
Division of Gastroenterology and Hepatology, University Hospital Center Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia.
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2015 (English)In: Inflammatory Bowel Diseases, ISSN 1078-0998, E-ISSN 1536-4844, Vol. 21, no 1, p. 121-131Article in journal (Refereed) Published
Abstract [en]

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 (&OV0556;) 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 &OV0556;5,408,174 (investigations: &OV0556;2,042,990 [38%], surgery: &OV0556;1,427,648 [26%], biologicals: &OV0556;781,089 [14%], and standard treatment: &OV0556;1,156,520 [22%)]). Mean crude expenditure per patient in Western Europe (Eastern Europe) with Crohn's disease: investigations &OV0556;1803 (&OV0556;2160) (P = 0.44), surgery &OV0556;11,489 (&OV0556;13,973) (P = 0.14), standard treatment &OV0556;1027 (&OV0556;824) (P = 0.51), and biologicals &OV0556;7376 (&OV0556;8307) (P = 0.31). Mean crude expenditure per patient in Western Europe (Eastern Europe) with ulcerative colitis: investigations &OV0556;1189 (&OV0556;1518) (P < 0.01), surgery &OV0556;18,414 (&OV0556;12,395) (P = 0.18), standard treatment &OV0556;896 (&OV0556;798) (P < 0.05), and biologicals &OV0556;5681 (&OV0556;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.

Place, publisher, year, edition, pages
2015. Vol. 21, no 1, p. 121-131
Keywords [en]
epidemiology; outcomes research; Crohn's disease; ulcerative colitis; economics of IBD therapies
National Category
Gastroenterology and Hepatology
Identifiers
URN: urn:nbn:se:oru:diva-41191DOI: 10.1097/MIB.0000000000000250ISI: 000348906500018PubMedID: 25437816OAI: oai:DiVA.org:oru-41191DiVA, id: diva2:779942
Funder
Swedish Research Council, 521-2011-2764
Note

Funding Agencies:

Danish Colitis Crohn Patients Organization (CCF)

Vibeke Binder and Povl Riis' Foundation

Scientific Council at Herlev Hospital

Sigrid Rigmor Moran Foundation

Aage and Johanne Louis-Hansens Foundation

Munkholm Foundation

C. C. Klestrup and Henriette Klestrup Foundation

Knud and Dagny Gad Andresens Foundation

Else and Mogens Wedell-Wedellsborgs Foundation

Direktor Jacob Madsen and Olga Madsens Foundation

ScanVet

Torben og Alice Frimodt Foundation

Laegernes forsikringsforening af

Bengt Ihre's foundation

Örebro University Hospital Research Foundation

Swedish Society of Medicine

Research Council of South-East Sweden

County Council of Östergötland

Swedish Organization for the study of inflammatory bowel disease

Competitive State Research Financing of the Expert Responsibility Area of Tampere University Hospital

European Crohn's and Colitis Organization

Available from: 2015-01-13 Created: 2015-01-13 Last updated: 2017-12-05Bibliographically approved

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Halfvarson, Jonas

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