Health care costs associated with Australian tertiary inflammatory bowel disease care

Introduction: We aimed to describe the total costs of illness for IBD patients and compare the costs of patients with active disease to those with inactive disease.Materials and methods: Resource use for IBD management was itemized for attributable costs (AUD) among all IBD patients over a 12-month period at an Australian hospital.Results: One hundred and eighty-three patients were included (87 ulcerative colitis (UC); 93 Crohn's disease (CD); three IBD-unclassified). The median (IQR) annual overall cost was higher in the CD versus UC group ($15,648 versus $5017; p<.001). The difference in cost between CD and UC was influenced by the difference in outpatient costs for CD patients $9602 ($4311-$29,805) versus $4867 ($3220-$7249), p<.001). The cost of treating patients with active disease was $3461 ($1607-$11,771) and was higher in the CD versus the UC group ($6098 ($2168-$16,471) versus $1638 ($1401-$3767); p=.026) and was influenced by inpatient admissions. The cost of treating patients in remission was $2090 ($1552-$12,954) and was higher in the CD versus the UC group [$7977 ($1579-$14,304) versus $1848 ($1508-$6601); p=.236].Conclusions: There is a discrepancy in costs of inpatient versus outpatient IBD management and treating active disease compared with disease in remission. Proactive care may help prevent disease reaching a severity whereby reactive management of active disease is required.