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Longitudinal Trends in the Direct Costs and Health Care Utilization Ascribable to Inflammatory Bowel Disease in the Biologic Era: Results From a Canadian Population-Based Analysis.
Targownik, Laura E; Kaplan, Gilaad G; Witt, Julia; Bernstein, Charles N; Singh, Harminder; Tennakoon, Aruni; Aviña Zubieta, Antonio; Coward, Stephanie B; Jones, Jennifer; Kuenzig, M Ellen; Murthy, Sanjay K; Nguyen, Geoffrey C; Peña-Sánchez, Juan Nicolás; Benchimol, Eric I.
Afiliación
  • Targownik LE; Section of Gastroenterology, Division of Internal Medicine, Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
  • Kaplan GG; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
  • Witt J; Department of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta, Calgary, Alberta, Canada.
  • Bernstein CN; Department of Economics, Faculty of Arts, University of Manitoba, Winnipeg, Manitoba, Canada.
  • Singh H; Section of Gastroenterology, Division of Internal Medicine, Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
  • Tennakoon A; Section of Gastroenterology, Division of Internal Medicine, Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
  • Aviña Zubieta A; Department of Community Health Sciences, Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
  • Coward SB; Section of Gastroenterology, Division of Internal Medicine, Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
  • Jones J; Arthritis Research Centre, University of British Columbia, Vancouver British Columbia, Canada.
  • Kuenzig ME; Department of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta, Calgary, Alberta, Canada.
  • Murthy SK; Department of Internal Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
  • Nguyen GC; Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Eastern Ontario, Children's Hospital of Eastern Ontario IBD Centre, Ottawa, Ontario, Canada.
  • Peña-Sánchez JN; The Ottawa Hospital IBD Centre, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada.
  • Benchimol EI; Mount Sinai Hospital Inflammatory Bowel Disease Centre, University of Toronto, Toronto, Ontario, Canada.
Am J Gastroenterol ; 115(1): 128-137, 2020 01.
Article en En | MEDLINE | ID: mdl-31895723
OBJECTIVES: The prevalence of inflammatory bowel disease (IBD) is increasing. The total direct costs of IBD have not been assessed on a population-wide level in the era of biologic therapy. DESIGN: We identified all persons with IBD in Manitoba between 2005 and 2015, with each matched to 10 controls on age, sex, and area of residence. We enumerated all hospitalizations, outpatient visits and prescription medications including biologics, and their associated direct costs. Total and per capita annual IBD-attributable costs and health care utilization (HCU) were determined by taking the difference between the costs/HCU accrued by an IBD case and their controls. Generalized linear modeling was used to evaluate trends in direct costs and Poisson regression for trends in HCU. RESULTS: The number of people with IBD in Manitoba increased from 6,323 to 7,603 between 2005 and 2015. The total per capita annual costs attributable to IBD rose from $3,354 in 2005 to $7,801 in 2015, primarily driven by an increase in per capita annual anti-tumor necrosis factor costs, which rose from $181 in 2005 to $5,270 in 2015. There was a significant decline in inpatient costs for CD ($99 ± 25/yr. P < 0.0001), but not for ulcerative colitis ($8 increase ±$18/yr, P = 0.63). DISCUSSION: The direct health care costs attributable to IBD have more than doubled over the 10 years between 2005 and 2015, driven mostly by increasing expenditures on biological medications. IBD-attributable hospitalization costs have declined modestly over time for persons with CD, although no change was seen for patients with ulcerative colitis.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Costos Directos de Servicios / Productos Biológicos / Colitis Ulcerosa / Enfermedad de Crohn Tipo de estudio: Health_economic_evaluation / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Aspecto: Implementation_research Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Am J Gastroenterol Año: 2020 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Costos Directos de Servicios / Productos Biológicos / Colitis Ulcerosa / Enfermedad de Crohn Tipo de estudio: Health_economic_evaluation / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Aspecto: Implementation_research Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Am J Gastroenterol Año: 2020 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos