In the Journals

Lifetime costs of IBD care may be higher than previous estimates

Researchers from the Hospital of the University of Pennsylvania estimated that the prevalent populations of patients with Crohn’s disease and ulcerative colitis in the United States will incur more than $400 billion and $300 billion in lifetime total health care costs, respectively.

Gary R. Lichtenstein, MD, and colleagues wrote that previous studies have had wide-ranging estimates, from approximately $180,000 to $310,000 for adults with CD to about $237,000 for children with UC. However, those estimates did not take all relevant factors into account.

“A common limitation of previous studies is that costs are not reported by age at diagnosis, although the expected lifetime burden is likely to be higher for patients diagnosed at younger ages,” they wrote. “Furthermore, because of treatment innovation, lifetime health care costs estimated in previous studies, particularly in the pre-biologic era, may not accurately reflect the current landscape.”

Researchers compared data from 78,620 patients with CD and 85,755 patients with UC with propensity score-match controls from the Truven Health MarketScan and insurance claims databases to estimate the lifetime health care costs incurred by patients with IBD by age at diagnosis. They measured both lifetime total and lifetime incremental cost, defined as the difference between costs of patients with CD or UC vs. matched controls.

Among patients with CD, the lifetime incremental cost was $707,711 for patients diagnosed between ages 0 and 11 years and $177,614 for patients diagnosed at 70 years or older. The average lifetime incremental cost for a CD diagnosis at any age was $416,352, and the lifetime total cost was $622,056.

For patients diagnosed with UC between ages 0 and 11 years, the lifetime incremental cost was $369,955, while the cost was $132,396 for patients diagnosed at 70 years or older. The average lifetime incremental cost for a UC diagnosis at any age was $230,102, and the lifetime total cost was $405,496.

With these estimates, investigators wrote that the prevalent populations of patients with CD or UC in the United States are expected to incur lifetime total costs of $498 billion and $337 billion, respectively.

Lichtenstein and colleagues wrote that the costs of care for IBD could be further impacted by new therapies.

“As more data on patients are collected, continued efforts should include assessing health care costs considering both short- and long-term patient outcomes and potential drivers of cost that can be used to further validate our findings,” they wrote. “The high lifetime cost burden in CD and UC highlights the urgent need for continued efforts to improve treatments and disease management leading to better patient outcomes, particularly in younger patients diagnosed with CD or UC.” by Alex Young

Disclosures: Lichtenstein reports being a consultant for AbbVie, Actavis, Celgene, Ferring, Hospira, Janssen, Luitpold/American Regent, Merck, Pfizer, Prometheus Laboratories, Romark, Salix Pharmaceuticals/Valeant, Santarus, Shire Pharmaceuticals, Takeda and UCB. He also reports receiving a grant from Celgene. Please see the full study for all other authors’ relevant financial disclosures.

Researchers from the Hospital of the University of Pennsylvania estimated that the prevalent populations of patients with Crohn’s disease and ulcerative colitis in the United States will incur more than $400 billion and $300 billion in lifetime total health care costs, respectively.

Gary R. Lichtenstein, MD, and colleagues wrote that previous studies have had wide-ranging estimates, from approximately $180,000 to $310,000 for adults with CD to about $237,000 for children with UC. However, those estimates did not take all relevant factors into account.

“A common limitation of previous studies is that costs are not reported by age at diagnosis, although the expected lifetime burden is likely to be higher for patients diagnosed at younger ages,” they wrote. “Furthermore, because of treatment innovation, lifetime health care costs estimated in previous studies, particularly in the pre-biologic era, may not accurately reflect the current landscape.”

Researchers compared data from 78,620 patients with CD and 85,755 patients with UC with propensity score-match controls from the Truven Health MarketScan and insurance claims databases to estimate the lifetime health care costs incurred by patients with IBD by age at diagnosis. They measured both lifetime total and lifetime incremental cost, defined as the difference between costs of patients with CD or UC vs. matched controls.

Among patients with CD, the lifetime incremental cost was $707,711 for patients diagnosed between ages 0 and 11 years and $177,614 for patients diagnosed at 70 years or older. The average lifetime incremental cost for a CD diagnosis at any age was $416,352, and the lifetime total cost was $622,056.

For patients diagnosed with UC between ages 0 and 11 years, the lifetime incremental cost was $369,955, while the cost was $132,396 for patients diagnosed at 70 years or older. The average lifetime incremental cost for a UC diagnosis at any age was $230,102, and the lifetime total cost was $405,496.

With these estimates, investigators wrote that the prevalent populations of patients with CD or UC in the United States are expected to incur lifetime total costs of $498 billion and $337 billion, respectively.

Lichtenstein and colleagues wrote that the costs of care for IBD could be further impacted by new therapies.

“As more data on patients are collected, continued efforts should include assessing health care costs considering both short- and long-term patient outcomes and potential drivers of cost that can be used to further validate our findings,” they wrote. “The high lifetime cost burden in CD and UC highlights the urgent need for continued efforts to improve treatments and disease management leading to better patient outcomes, particularly in younger patients diagnosed with CD or UC.” by Alex Young

Disclosures: Lichtenstein reports being a consultant for AbbVie, Actavis, Celgene, Ferring, Hospira, Janssen, Luitpold/American Regent, Merck, Pfizer, Prometheus Laboratories, Romark, Salix Pharmaceuticals/Valeant, Santarus, Shire Pharmaceuticals, Takeda and UCB. He also reports receiving a grant from Celgene. Please see the full study for all other authors’ relevant financial disclosures.