Health care cost analysis in a population-based inception cohort of inflammatory bowel disease patients in the first year of diagnosis

Olga Niewiadomski, Corrie Studd, Christopher Hair, Jarrad Wilson, John McNeill, Ross Knight, Emily Prewett, Paul Dabkowski, Damian Dowling, Sina Alexander, Benjamin Allen, Mark Tacey, William Connell, Paul Desmond, Sally Bell

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Background: There are limited prospective population-based data on the health care cost of IBD in the post-biologicals era. A prospective registry that included all incident cases of inflammatory bowel disease [IBD] was established to study disease progress and health cost. Aim: To prospectively assess health care costs in the first year of diagnosis among a well-characterised cohort of newly diagnosed IBD patients. Method: Incident cases of IBD were prospectively identified in 2007-2008 and 2010-2013 from multiple health care providers, and enrolled into the population-based registry. Health care resource utilisation for each patient was collected through active surveillance of case notes and investigations including specialist visits, diagnostic tests, medications, medical hospitalisation, and surgery. Results: Off 276 incident cases of IBD, 252 [91%] were recruited to the registry, and health care cost was calculated for 242 (146 Crohn's disease [CD] and 96 ulcerative colitis [UC] patients). The median cost in CD was higher at A$5905 per patient (interquartile range [IQR]: A$1571-$91,324) than in UC at A$4752 [IQR: A$1488-A$58,072]. In CD, outpatient resources made up 55% of all cost, with medications accounting for 32% of total cost [15% aminosalicylates, 15% biological therapy], followed by surgery [31%], and diagnostic testing [21%]. In UC, medications accounted for 39% of total cost [of which 37% was due to 5-aminosalicylates, and diagnostics 29%; outpatient cost contributed 71% to total cost. Conclusion: In the first year of diagnosis, outpatient resources account for the majority of cost in both CD and UC. Medications are the main cost driver in IBD.

Original languageEnglish
Article numberjjv117
Pages (from-to)988-996
Number of pages9
JournalJournal of Crohn's and Colitis
Issue number11
Publication statusPublished - Nov 2015


  • Crohn's disease
  • health cost analysis
  • Inflammatory bowel disease
  • population-based
  • ulcerative colitis

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