Gut and Liver https://doi.org/10.5009/gnl19023 Changes in Direct Healthcare Costs Before and After the Diagnosis of Inflammatory Bowel Disease: A Nationwide Population-Based Study
Author Information
Jooyoung Lee1,2, Jong Pil Im1*, Kyungdo Han3, Jihye Kim1, 4, Hyun Jung Lee1, Jaeyoung Chun1, and Joo Sung Kim1,2
1Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
2Department of Internal Medicine, Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea
3Department of Medical Statistics, College of Medicine, Catholic University of Korea, Seoul, Korea
4Department of Internal Medicine, CHA Gangnam Medical Center, CHA University, Seoul, Korea

Jong Pil Im
Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, 101, aehak-ro, Jongno-gu, Seoul 03090, Korea
Tel: +82-2-2072-0638, E-mail: jpim0911@snu.ac.kr
© The Korean Society of Gastroenterology, the Korean Society of Gastrointestinal Endoscopy, the Korean Society of Neurogastroenterology and Motility, Korean College of Helicobacter and Upper Gastrointestinal Research, Korean Association the Study of Intestinal Diseases, the Korean Association for the Study of the Liver, Korean Pancreatobiliary Association, and Korean Society of Gastrointestinal Cancer. All rights reserved.

Abstract
Background/Aims: We aimed to investigate the differences in direct healthcare costs between patients with and without inflammatory bowel disease (IBD) and changes in direct healthcare costs before and after IBD diagnosis. Methods: This population-based study identified 34,167 patients with IBD (23,153 patients with Crohn's disease and 11,014 patients with ulcerative colitis) and 102,501 age-and sex-matched subjects without IBD (the control group) from the National Health Insurance database using the International Classification of Disease, 10th revision codes and the rare intractable disease registration program codes. The mean healthcare costs per patient were analyzed for three years before and after IBD diagnosis, with follow-up data available until 2015. Results: Total direct healthcare costs increased and peaked at $2,396 during the first year after IBD diagnosis, but subsequently dropped sharply to $1,478 during the second year after diagnosis. Total healthcare costs were higher for the IBD patients than for the control group, even in the third year before the diagnosis ($497 vs $402, p<0.001). The costs for biologics for the treatment of IBD increased steeply over time, rising from $720.8 in the first year after diagnosis to $1,249.6 in the 3rd year after diagnosis (p<0.001). Conclusion: IBD patients incurred the highest direct healthcare costs during the first year after diagnosis. IBD patients had higher costs than the control group even before diagnosis. The cost of biologics increased steeply over time, and it can be assumed that biologics could be the main driver of costs during the early period after IBD diagnosis.
Keywords: Inflammatory bowel disease; Healthcare; Cost; Biologics
Abstract
Background/Aims: We aimed to investigate the differences in direct healthcare costs between patients with and without inflammatory bowel disease (IBD) and changes in direct healthcare costs before and after IBD diagnosis. Methods: This population-based study identified 34,167 patients with IBD (23,153 patients with Crohn's disease and 11,014 patients with ulcerative colitis) and 102,501 age-and sex-matched subjects without IBD (the control group) from the National Health Insurance database using the International Classification of Disease, 10th revision codes and the rare intractable disease registration program codes. The mean healthcare costs per patient were analyzed for three years before and after IBD diagnosis, with follow-up data available until 2015. Results: Total direct healthcare costs increased and peaked at $2,396 during the first year after IBD diagnosis, but subsequently dropped sharply to $1,478 during the second year after diagnosis. Total healthcare costs were higher for the IBD patients than for the control group, even in the third year before the diagnosis ($497 vs $402, p<0.001). The costs for biologics for the treatment of IBD increased steeply over time, rising from $720.8 in the first year after diagnosis to $1,249.6 in the 3rd year after diagnosis (p<0.001). Conclusion: IBD patients incurred the highest direct healthcare costs during the first year after diagnosis. IBD patients had higher costs than the control group even before diagnosis. The cost of biologics increased steeply over time, and it can be assumed that biologics could be the main driver of costs during the early period after IBD diagnosis.
Keywords: Inflammatory bowel disease; Healthcare; Cost; Biologics
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