The Evolution of Health Care Utilisation and Costs for Inflammatory Bowel Disease Over Ten Years

被引:45
作者
Pillai, Nadia [1 ]
Dusheiko, Mark [1 ,2 ,3 ]
Maillard, Michel H. [4 ,5 ]
Rogler, Gerhard [6 ]
Brungger, Beat [7 ]
Bahler, Caroline [7 ]
Pittet, Valerie E. H. [1 ]
Anderegg, Claudia
Bauerfeind, Peter
Beglinger, Christoph
Begre, Stefan
Belli, Dominique
Bengoa, Jose M.
Biedermann, Luc
Bigler, Beat
Binek, Janek
Blattmann, Mirjam
Boehm, Stephan
Borovicka, Jan
Braegger, Christian P.
Brunner, Nora
Buhr, Patrick
Burnand, Bernard
Burri, Emanuel
Buyse, Sophie
Cremer, Matthias
Criblez, Dominique H.
de Saussure, Philippe
Degen, Lukas
Delarive, Joakim
Doerig, Christopher
Dora, Barbara
Dorta, Gian
Egger, Mara
Ehmann, Tobias
El-Wafa, Ali
Engelmann, Matthias
Ezri, Jessica
Felley, Christian
Fliegner, Markus
Fournier, Nicolas
Fraga, Montserrat
Frei, Pascal
Frei, Remus
Fried, Michael
Froehlich, Florian
Funk, Christian
Furlano, Raoul Ivano
Gallot-Lavallee, Suzanne
Geyer, Martin
机构
[1] Lausanne Univ Hosp, Inst Social & Prevent Med IUMSP, Lausanne, Switzerland
[2] Univ York, Ctr Hlth Econ, York, N Yorkshire, England
[3] Univ Lausanne, Fac Business & Econ HEC, Lausanne, Switzerland
[4] Gastroenterol Beaulieu SA, Crohn & Colitis Ctr, Lausanne, Switzerland
[5] Lausanne Univ Hosp, Serv Gastroenterol & Hepatol, Lausanne, Switzerland
[6] Univ Hosp Zurich, Dept Gastroenterol & Hepatol, Zurich, Switzerland
[7] Helsana Grp, Dept Hlth Sci, POB 8081, Zurich, Switzerland
基金
瑞士国家科学基金会;
关键词
IBD; Crohn's disease; ulcerative colitis; health economics; CROHNS-DISEASE; ULCERATIVE-COLITIS; EXTRAINTESTINAL MANIFESTATIONS; INCEPTION COHORT; UNITED-STATES; PREVALENCE; SWITZERLAND; RESOURCES; PROFILE; TIME;
D O I
10.1093/ecco-jcc/jjz003
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background and Aims Inflammatory bowel disease [IBD] places an economic strain on health systems due to expensive pharmaceutical therapy, risk of hospitalisation and surgery, and long-term monitoring. The evolving treatment guidelines advocate rapid scale-up to biologic agents in order to improve health outcomes and quality of life. This study evaluated changes in health care utilisation and expenditures for IBD in Switzerland over time. Methods We extracted clinical, patient, and resource consumption data from the Swiss IBD Cohort Study between 2006 and 2016. Average unit costs for IBD-related events were derived from Swiss claims data and pharmaceutical price lists. We used multivariate regression, controlling for patient-level characteristics, to estimate trends and determinants of direct and indirect costs and resource utilisation. Results We included 2365 adults diagnosed with Crohn's disease [CD; N = 1353] and ulcerative colitis [UC; N = 1012]. From 2006-16, mean health care expenditures per patient per year were 9504 euros [70% drugs, 23% inpatient, 7% outpatient] for CD and 5704 euros [68% drugs, 22% inpatient, 10% outpatient] for UC. Health care costs increased by 7% [CD] and 10% [UC] per year, largely due to rising pharmaceutical expenditures driven by increased biologic agent use. Inpatient, outpatient, and indirect costs fluctuated and did not offset increased pharmaceutical costs. Disease characteristics were important predictors of costs. Conclusions Increased expenditure for IBD was marked by a shift towards greater pharmaceutical management over the past decade. This study highlights the need to identify cost-effective treatment strategies in the face of increased uptake and expenditures associated with innovative treatments.
引用
收藏
页码:744 / 754
页数:11
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