The Magnitude of Crohn's Disease Direct Costs in Health Care Systems (from Different Perspectives): A Systematic Review

Autores da FMUP

• Claudia Camila Rodrigues Pereira Dias

  Autor

• Fernando José Magro Dias

  Autor

Participantes de fora da FMUP

• Santiago, M
• Alves, C
• Ministro, P
• Gonçalves, R
• Carvalho, D
• Portela, F
• Correia, L
• Lago, P

Unidades de investigação

• Biomedicina

• Laboratório Associado RISE- Rede de Investigação em Saúde

  

  Investigador

  Fernando Carlos De Landér Schmitt

• Recursos Comuns

  

  Investigador

  Guilhermina Maria Da Silva Rêgo

• RISE-Health

  

  Investigador

  Fernando Carlos De Landér Schmitt

Abstract

Background The prevalence of inflammatory bowel disease (IBD) has been increasing worldwide, causing high impact on the quality of life of patients and an increasing burden for health care systems. In this systematic review, we reviewed the literature concerning the direct costs of Crohn's disease (CD) for health care systems from different perspectives: regional, economic, and temporal. Methods We searched for original real-world studies examining direct medical health care costs in Crohn's disease. The primary outcome measure was the mean value per patient per year (PPY) of total direct health care costs for CD. Secondary outcomes comprised hospitalization, surgery, CD-related medication (including biologics), and biologics mean costs PPY. Results A total of 19 articles were selected for inclusion in the systematic review. The studies enrolled 179 056 CD patients in the period between 1997 and 2016. The pooled mean total cost PPY was euro6295.28 (95% CI, euro4660.55-euro8503.41). The pooled mean hospitalization cost PPY for CD patients was euro2004.83 (95% CI, euro1351.68-euro2973.59). The major contributors for the total health expenditure were biologics (euro5554.58) and medications (euro3096.53), followed by hospitalization (euro2004.83) and surgery (euro1883.67). No differences were found between regional or economic perspectives, as confidence intervals overlapped. However, total costs were significantly higher after 2010. Conclusions Our review highlighted the burden of CD for health care systems from different perspectives (regional, economic, and temporal) and analyzed the impact of the change of IBD treatment paradigm on total costs. Reducing the overall burden can depend on the increase of remission rates to further decrease hospitalizations and surgeries.

Keywords

• Crohn's disease; health care costs; economic burden; mean value per patient per year (PPY)