P017 Cost burden of CD and UC is significantly higher up to 10 years before diagnosis: A Danish register-based study

• Published in: The American journal of gastroenterology Vol. 114; no. 1; p. S5
• Main Authors: Kasper, Vadstrup, Sarah, Alulis, Andras, Borsi, Tine, Jørgensen, Nina, Gustafsson, Sandra, Stallknecht, Niels, Qvist, Pia, Munkholm
• Format: Journal Article
• Language: English
• Published: 01.07.2019
• DOI: 10.14309/01.ajg.0000578140.35891.8a
• ISSN: 0002-9270

BACKGROUND: Population-based data on the economic burden of Crohn's disease (CD) and ulcerative colitis (UC) is limited and the burden prior to diagnosis has not yet been reported. This study estimates the ten-year societal costs prior to the diagnoses of CD and UC patients and the 5-year attributable costs after diagnosis in a national patient cohort from Denmark. METHODS: In this register study using the Danish National Patient Register and the Danish longitudinal database on employment (the DREAM database), incident CD and UC patients between 2002–2016 were assessed and matched on age and gender with one non-diseased control. Ten-year average annual costs were calculated for cases and controls prior to diagnosis. Five-year attributable costs after the date of diagnosis were also estimated using a difference-in-difference approach. Costs included health care services, prescription medicine, home care services and production loss. Odds ratios for the occurrence of diseases requiring a hospital contact before diagnosis were estimated using logistic regression analyses. RESULTS: The study included 10,302 incident CD and 22,144 incident UC patients. Average costs were significantly higher for CD/UC patients than controls throughout the ten-year period prior to diagnosis. The difference increased over time and equaled €3,377 for CD and €2,960 for UC patients in the year before diagnosis. CD/UC patients had significantly more hospital contacts than controls prior to inflammatory bowel disease (IBD) diagnosis, with 51.6% of CD patients and 52.4% of UC patients having other diagnoses related to the digestive system. The average attributable costs were highest the first year after diagnosis, equalling €12,919 per CD patient and €6,501 per UC patient. Hospital admission costs accounted for 36% for CD and 31% for UC patients—prescription medicine for 3% and 7%, respectively. CONCLUSION(S): This study provides population-based evidence of the substantial economic burden of CD and UC 10 years prior to and 5 years after diagnosis. These findings may indicate a significant diagnostic delay of CD and UC and warrants more research into the possible causes.