Changes in Direct Healthcare Costs before and after the Diagnosis of Inflammatory Bowel Disease: A Nationwide Population-Based Study
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Background/Aims: We aimed to investigate the differences in direct healthcare costs between patients with and without inflammatory bowel disease (IBD) and changes in direct healthcare costs before and after IBD diagnosis. Methods: This population-based study identified 34,167 patients with IBD (11,014 patients with Crohn’s disease and 23,153 patients with ulcerative colitis) and 102,501 age-and sex-matched subjects without IBD (the control group) from the National Health Insurance database using the International Classification of Disease, 10th revision codes and the rare intractable disease registration program codes. The mean healthcare costs per patient were analyzed for 3 years before and after IBD diagnosis, with follow-up data available until 2015. Results: Total direct healthcare costs increased and peaked at $2,396 during the first year after IBD diagnosis, but subsequently dropped sharply to $1,478 during the second year after diagnosis. Total healthcare costs were higher for the IBD patients than for the control group, even in the third year before the diagnosis ($497 vs $402, p<0.001). The costs for biologics for the treatment of IBD increased steeply over time, rising from $720.8 in the first year after diagnosis to $1,249.6 in the third year after diagnosis (p<0.001). Conclusions: IBD patients incurred the highest direct healthcare costs during the first year after diagnosis. IBD patients had higher costs than the control group even before diagnosis. The cost of biologics increased steeply over time, and it can be assumed that biologics could be the main driver of costs during the early period after IBD diagnosis.
Abstract
Background/Aims: We aimed to investigate the differences in direct healthcare costs between patients with and without inflammatory bowel disease (IBD) and changes in direct healthcare costs before and after IBD diagnosis. Methods: This population-based study identified 34,167 patients with IBD (11,014 patients with Crohn’s disease and 23,153 patients with ulcerative colitis) and 102,501 age-and sex-matched subjects without IBD (the control group) from the National Health Insurance database using the International Classification of Disease, 10th revision codes and the rare intractable disease registration program codes. The mean healthcare costs per patient were analyzed for 3 years before and after IBD diagnosis, with follow-up data available until 2015. Results: Total direct healthcare costs increased and peaked at $2,396 during the first year after IBD diagnosis, but subsequently dropped sharply to $1,478 during the second year after diagnosis. Total healthcare costs were higher for the IBD patients than for the control group, even in the third year before the diagnosis ($497 vs $402, p<0.001). The costs for biologics for the treatment of IBD increased steeply over time, rising from $720.8 in the first year after diagnosis to $1,249.6 in the third year after diagnosis (p<0.001). Conclusions: IBD patients incurred the highest direct healthcare costs during the first year after diagnosis. IBD patients had higher costs than the control group even before diagnosis. The cost of biologics increased steeply over time, and it can be assumed that biologics could be the main driver of costs during the early period after IBD diagnosis.
참고문헌 (32)
- Gunnarsson C, "Direct health care insurer and out-of-pocket expenditures of inflammatory bowel disease : evidence from a US national survey", Dig Dis Sci, 57, pp.3080~3091 (2012)
- Kappelman MD, "Direct health care costs of Crohn’s disease and ulcerative colitis in US children and adults", Gastroenterology, 135, pp.1907~1913 (2008)
- Rocchi A, "Inflammatory bowel disease : a Canadian burden of illness review", Can J Gastroenterol, 26, pp.811~817 (2012)
- van der Valk ME, "Healthcare costs of inflammatory bowel disease have shifted from hospitalisation and surgery towards anti-TNFalpha therapy : results from the COIN study", Gut, 63, pp.72~79 (2014)
- Ng SC, "Emerging leadership lecture : inflammatory bowel disease in Asia : emergence of a"Western"disease", J Gastroenterol Hepatol, 30, pp.440~445 (2015)
- Prashant Singh, "Pivot to Asia: inflammatory bowel disease burden", Intestinal research, 15(1), pp.138~141 (2017), 대한장연구학회
- Yang SK, "Epidemiology of inflammatory bowel disease in the Songpa-Kangdong district, Seoul, Korea, 1986-2005 : a KASID study", Inflamm Bowel Dis, 14, pp.542~549 (2008)
- Kim HJ, "Incidence and natural course of inflammatory bowel disease in Korea, 2006-2012 : a nationwide population-based study", Inflamm Bowel Dis, 21, pp.623~630 (2015)
- Wee Khoon Ng, "Changing epidemiological trends of inflammatory bowel disease in Asia", Intestinal research, 14(2), pp.111~119 (2016), 대한장연구학회
- Jung YS, "Incidence and clinical outcomes of inflammatory bowel disease in South Korea, 2011-2014 : a nationwide population-based study", Dig Dis Sci, 62, pp.2102~2112 (2017)
- 이용호, "Data Analytic Process of a Nationwide Population-Based Study Using National Health Information Database Established by National Health Insurance Service", Diabetes and Metabolism Journal, 40(1), pp.79~82 (2016), 대한당뇨병학회[DOI]
- Kim ES, "Impact of weight changes on the incidence of diabetes mellitus : a Korean nationwide cohort study", Sci Rep, 8, pp.3735~ (2018)
- Park S, "Increased end-stage renal disease risk in patients with inflammatory bowel disease : a nationwide population-based study", World J Gastroenterol, 24, pp.4798~4808 (2018)
- Hosim Soh, "Increased Risk of Herpes Zoster in Young and Metabolically Healthy Patients with Inflammatory Bowel Disease: A Nationwide Population-Based Study", Gut and Liver, 13(3), pp.333~341 (2019), 거트앤리버 소화기연관학회협의회[DOI]
- Odes S, "Cost analysis and cost determinants in a European inflammatory bowel disease inception cohort with 10 years of follow-up evaluation", Gastroenterology, 131, pp.719~728 (2006)
- Drummond M, "Methods for the economic evaluation of health care programmes" (2015), Oxford University Press
- Niewiadomski O, "Health care cost analysis in a population-based inception cohort of inflammatory bowel disease patients in the first year of diagnosis", J Crohns Colitis, 9, pp.988~996 (2015)
- Kim JW, "Trends in health-care costs and utilization for inflammatory bowel disease from 2010 to 2014 in Korea : a nationwide population-based study", J Gastroenterol Hepatol, 33, pp.847~854 (2018)
- Mak LY, "Direct health-care cost utilization in Hong Kong inflammatory bowel disease patients in the initial 2 years following diagnosis", J Gastroenterol Hepatol, 33, pp.141~149 (2018)
- Petryszyn PW, "Costs in inflammatory bowel diseases", Prz Gastroenterol, 11, pp.6~13 (2016)
- Lönnfors S, "IBD and health-related quality of life : discovering the true impact", J Crohns Colitis, 8, pp.1281~1286 (2014)
- Moon CM, "Clinical factors and disease course related to diagnostic delay in Korean Crohn’s disease patients : results from the CONNECT Study", PLoS One, 10, pp.e0144390~ (2015)
- D’Haens G, "Early combined immunosuppression or conventional management in patients with newly diagnosed Crohn’s disease : an open randomized trial", Lancet, 371, pp.660~667 (2008)
- Schreiber S, "Increased response and remission rates in short-duration Crohn’s disease with subcutaneous certolizumab pegol : an analysis of PRECiSE 2 randomized maintenance trial data", Am J Gastroenterol, 105, pp.1574~1582 (2010)
- Colombel JF, "Early mucosal healing with infliximab is associated with improved long-term clinical outcomes in ulcerative colitis", Gastroenterology, 141, pp.1194~1201 (2011)
- Colombel JF, "Randomised clinical trial : deep remission in biologic and immunomodulator naïve patients with Crohn’s disease : a SONIC post hoc analysis", Aliment Pharmacol Ther, 41, pp.734~746 (2015)
- Jong Pil Im, "Changing treatment paradigms for the management of inflammatory bowel disease", The Korean Journal of Internal Medicine, 33(1), pp.28~35 (2018), 대한내과학회[DOI]
- Frolkis AD, "Risk of surgery for inflammatory bowel diseases has decreased over time : a systematic review and meta-analysis of population-based studies", Gastroenterology, 145, pp.996~1006 (2013)
- Rungoe C, "Changes in medical treatment and surgery rates in inflammatory bowel disease : a nationwide cohort study 1979-2011", Gut, 63, pp.1607~1616 (2014)
- Ferrari L, "Inflammatory bowel disease surgery in the biologic era", World J Gastrointest Surg, 8, pp.363~370 (2016)
- Konstantinos H. Katsanos, "Inflammatory Bowel Disease: Updates on Molecular Targets for Biologics", Gut and Liver, 11(4), pp.455~463 (2017), 거트앤리버 소화기연관학회협의회
- 김영선, "Impact of inflammatory bowel disease on daily life: an online survey by the Korean Association for the Study of Intestinal Diseases", Intestinal research, 15(3), pp.338~344 (2017), 대한장연구학회