دورية أكاديمية
Health-care costs of inflammatory bowel disease in a pan-European, community-based, inception cohort during 5 years of follow-up: a population-based study.
| العنوان: | Health-care costs of inflammatory bowel disease in a pan-European, community-based, inception cohort during 5 years of follow-up: a population-based study. |
|---|---|
| المؤلفون: | Burisch J; Department of Gastroenterology, North Zealand University Hospital, Frederikssund, Denmark. Electronic address: johan.burisch@regionh.dk., Vardi H; Department of Public Health, Ben-Gurion University of the Negev, Beer Sheva, Israel., Schwartz D; Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel; Department of Gastroenterology and Liver Diseases, Soroka Medical Centre, Beer Sheva, Israel., Friger M; Department of Public Health, Ben-Gurion University of the Negev, Beer Sheva, Israel., Kiudelis G; Department of Gastroenterology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania., Kupčinskas J; Department of Gastroenterology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania; Institute for Digestive Research, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania., Fumery M; Gastroenterology Unit, Epimad Registry, CHU Amiens Sud, Avenue Laennec-Salouel, Amiens University Hospital, Amiens, France., Gower-Rousseau C; Public Health, Epidemiology and Economic Health, Registre Epimad, Lille University, Lille, France; Lille Inflammation Research International Center LIRIC, Lille University, Lille, France., Lakatos L; Department of Internal Medicine, Csolnoky Ferenc Regional Hospital, Veszprem, Hungary., Lakatos PL; First Department of Medicine, Semmelweis University, Budapest, Hungary; Division of Gastroenterology, McGill University Health Center, Montreal, QC, Canada., D'Incà R; Department of Surgical, Oncological, and Gastroenterological Sciences, Azienda, University of Padua, Padua, Italy., Sartini A; Gastroenterology Unit, Bufalini Hospital Cesena, AUSL della Romagna, Rimini, Italy., Valpiani D; UO Gastroenterologia ed Endoscopia Digestiva, Hospital Morgagni Pierantoni, Forlì, Italy., Giannotta M; Azienda USL Toscana Centro, Florence, Italy., Arebi N; Inflammatory Bowel Disease Department, Imperial College London, London, UK., Duricova D; Inflammatory Bowel Disease Clinical and Research Centre, ISCARE, Prague, Czech Republic., Bortlik M; Inflammatory Bowel Disease Clinical and Research Centre, ISCARE, Prague, Czech Republic; Institute of Pharmacology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic., Chetcuti Zammit S; Division of Gastroenterology, Mater Dei Hospital, Msida, Malta., Ellul P; Division of Gastroenterology, Mater Dei Hospital, Msida, Malta., Pedersen N; Gastroenterology Department, Slagelse Hospital, Slagelse, Denmark., Kjeldsen J; Gastroenterology Department, Odense University Hospital, Odense, Denmark., Midjord JMM; Medical Department, The National Hospital of the Faroe Islands, Torshavn, Faroe Islands., Nielsen KR; Medical Department, The National Hospital of the Faroe Islands, Torshavn, Faroe Islands., Winther Andersen K; IRS-Center Soenderjylland, University Hospital of Southern Denmark, Aabenraa, Denmark., Andersen V; IRS-Center Soenderjylland, University Hospital of Southern Denmark, Aabenraa, Denmark; Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark., Katsanos KH; Division of Gastroenterology, School of Health Sciences, University Hospital and University of Ioannina, Ioannina, Greece., Christodoulou DK; Division of Gastroenterology, School of Health Sciences, University Hospital and University of Ioannina, Ioannina, Greece., Domislovic V; Department of Gastroenterology, Hepatology and Nutrition, University Hospital Centre Zagreb, Zagreb, Croatia., Krznaric Z; Department of Gastroenterology, Hepatology and Nutrition, University Hospital Centre Zagreb, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia., Sebastian S; Hull University Teaching Hospitals NHS Trust, Hull, UK; Hull York Medical School, Hull, UK., Oksanen P; Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland; Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland., Collin P; Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland., Barros L; Department of Gastroenterology, Centro Hospitalar de São João EPE, Porto, Portugal., Magro F; Department of Gastroenterology, Centro Hospitalar de São João EPE, Porto, Portugal; Department of Biomedicine, Institute of Pharmacology, Faculty of Medicine, Porto University, Porto, Portugal., Salupere R; Division of Gastroenterology, Tartu University Hospital, University of Tartu, Tartu, Estonia., Kievit HAL; Department of Medicine, Herning Central Hospital, Herning, Denmark., Goldis A; Clinic of Gastroenterology, Victor Babeş University of Medicine, Timisoara, Romania., Kaimakliotis IP; Nicosia Private Practice, Nicosia, Cyprus., Dahlerup JF; Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark., Eriksson C; Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden., Halfvarson J; Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden., Fernandez A; Department of Gastroenterology, Hospital Povisa, Vigo, Spain., Hernandez V; Department of Gastroenterology, Instituto de Investigación Sanitaria Galicia Sur, Hospital Alvaro Cunqueiro, Xerencia Xestion Integrada de Vigo, Vigo, Spain., Turcan S; Department of Gastroenterology, State University of Medicine and Pharmacy of the Republic of Moldova, Chisinau, Moldova., Belousova E; Department of Gastroenterology, Moscow Regional Research Clinical Institute, Moscow, Russia., Langholz E; Department of Gastroenterology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark., Munkholm P; Department of Gastroenterology, North Zealand University Hospital, Frederikssund, Denmark., Odes S; Department of Internal Medicine, Ben-Gurion University of the Negev, Beer Sheva, Israel. |
| مؤلفون مشاركون: | Epi-IBD group |
| المصدر: | The lancet. Gastroenterology & hepatology [Lancet Gastroenterol Hepatol] 2020 May; Vol. 5 (5), pp. 454-464. Date of Electronic Publication: 2020 Feb 13. |
| نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier B.V Country of Publication: Netherlands NLM ID: 101690683 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2468-1253 (Electronic) NLM ISO Abbreviation: Lancet Gastroenterol Hepatol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: [Amsterdam] : Elsevier B.V., [2016]- |
| مواضيع طبية MeSH: | Biological Products/*economics , Colitis, Ulcerative/*economics , Crohn Disease/*economics , Health Care Costs/*statistics & numerical data, Adult ; Biological Products/therapeutic use ; Colitis, Ulcerative/diagnosis ; Colitis, Ulcerative/therapy ; Crohn Disease/diagnosis ; Crohn Disease/therapy ; Diagnostic Techniques and Procedures/economics ; Digestive System Surgical Procedures/economics ; Europe ; Female ; Follow-Up Studies ; Health Care Costs/trends ; Hospitalization/economics ; Humans ; Male ; Middle Aged ; Prospective Studies |
| مستخلص: | Background: Inflammatory bowel disease (IBD) places a significant burden on health-care systems because of its chronicity and need for expensive therapies and surgery. With increasing use of biological therapies, contemporary data on IBD health-care costs are important for those responsible for allocating resources in Europe. To our knowledge, no prospective long-term analysis of the health-care costs of patients with IBD in the era of biologicals has been done in Europe. We aimed to investigate cost profiles of a pan-European, community-based inception cohort during 5 years of follow-up. Methods: The Epi-IBD cohort is a community-based, prospective inception cohort of unselected patients with IBD diagnosed in 2010 at centres in 20 European countries plus Israel. Incident patients who were diagnosed with IBD according to the Copenhagen Diagnostic Criteria between Jan 1, and Dec 31, 2010, and were aged 15 years or older the time of diagnosis were prospectively included. Data on clinical characteristics and direct costs (investigations and outpatient visits, blood tests, treatments, hospitalisations, and surgeries) were collected prospectively using electronic case-report forms. Patient-level costs incorporated procedures leading to the initial diagnosis of IBD and costs of IBD management during the 5-year follow-up period. Costs incurred by comorbidities and unrelated to IBD were excluded. We grouped direct costs into the following five categories: investigations (including outpatient visits and blood tests), conventional medical treatment, biological therapy, hospitalisation, and surgery. Findings: The study population consisted of 1289 patients with IBD, with 1073 (83%) patients from western Europe and 216 (17%) from eastern Europe. 488 (38%) patients had Crohn's disease, 717 (56%) had ulcerative colitis, and 84 (6%) had IBD unclassified. The mean cost per patient-year during follow-up for patients with IBD was €2609 (SD 7389; median €446 [IQR 164-1849]). The mean cost per patient-year during follow-up was €3542 (8058; median €717 [214-3512]) for patients with Crohn's disease, €2088 (7058; median €408 [133-1161]) for patients with ulcerative colitis, and €1609 (5010; median €415 [92-1228]) for patients with IBD unclassified (p<0·0001). Costs were highest in the first year and then decreased significantly during follow-up. Hospitalisations and diagnostic procedures accounted for more than 50% of costs during the first year. However, in subsequent years there was a steady increase in expenditure on biologicals, which accounted for 73% of costs in Crohn's disease and 48% in ulcerative colitis, in year 5. The mean annual cost per patient-year for biologicals was €866 (SD 3056). The mean yearly costs of biological therapy were higher in patients with Crohn's disease (€1782 [SD 4370]) than in patients with ulcerative colitis (€286 [1427]) or IBD unclassified (€521 [2807]; p<0·0001). Interpretation: Overall direct expenditure on health care decreased over a 5-year follow-up period. This period was characterised by increasing expenditure on biologicals and decreasing expenditure on conventional medical treatments, hospitalisations, and surgeries. In light of the expenditures associated with biological therapy, cost-effective treatment strategies are needed to reduce the economic burden of inflammatory bowel disease. Funding: Kirsten og Freddy Johansens Fond and Nordsjællands Hospital Forskningsråd. (Copyright © 2020 Elsevier Ltd. All rights reserved.) |
| فهرسة مساهمة: | Investigator: N Turk; S Cukovic-Cavka; A Nicolaou; M Lukas; O Shonová; B Blichfeldt; D Marker; K Carlsen; P Weimers; C Aalykke; K Kudsk; I Vind; N Thorsgaard; A Skamnelos; D Politis; Z Vegh; P Demenyi; S Nemethne Kramli; G Dal Piaz; A Santini; G Girardin; L Kupcinskas; L Jonaitis; I Valantiene; R Zykus; R Kucinskiene; D Lazar; I Nikulina; L de Castro; JR Pineda; S Pereira; J Martinez-Cadilla; L Sanroman; M Figueira; DM Ares; JI Rodriguez-Prada; A Carmona; C Gonzalez-Portela; UB Widen; S Myers; K Ashton; E Whitehead |
| المشرفين على المادة: | 0 (Biological Products) |
| تواريخ الأحداث: | Date Created: 20200217 Date Completed: 20200720 Latest Revision: 20200720 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1016/S2468-1253(20)30012-1 |
| PMID: | 32061322 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 2468-1253 |
|---|---|
| DOI: | 10.1016/S2468-1253(20)30012-1 |