P532. Economic burden of common comorbidities associated with ulcerative colitis
R.D. Cohen1, J. Rizzo2, A. Soliman3, M. Yang2, M. Skup2, P.M. Mulani2, J. Chao2, 1University of Chicago, Chicago, IL, United States, 2Abbott Laboratories, Abbott Park, IL, United States, 3University of Minnesota, Minneapolis, MN, United States
We compared medical utilisation and associated direct costs of privately insured US employees with ulcerative colitis (UC) and common comorbid conditions to employees with UC alone.
Employed patients (pts) 18–65 years old with ≥2 UC diagnoses (ICD-9: 556.xx) were selected from Truven Health MarketScan® Commercial Claims and Encounters Databases (1/1/2000–12/31/2010). Comorbidities identified during the 1-year baseline period prior to a randomly chosen UC diagnosis date (index date) included: autoimmune disease, pulmonary disease, diabetes, hypertension, malignancy, psychiatric disorders, and heart disease. Medical resource utilisation (overnight hospitalisations, emergency department [ED] visits, hospital day visits, and physician outpatient [OP] visits) and associated costs during the 1-year period following the index date were compared for pts with ≥1 comorbidity vs. those without. A multivariate analysis compared direct costs adjusting for age, sex, and Charlson score. Analyses were also performed for a subgroup of pts with moderate to severe UC (UC hospitalisation or use of systemic corticosteroids, immunosuppressants, or biologics).
10,264 UC pts with ≥1 common comorbidity at baseline and 12,604 UC pts with no common comorbidity at baseline were included. Medical resource utilisation was significantly greater in the group with comorbidities vs without (0.33 vs 0.18 ED visits; 0.34 vs 0.16 overnight hospitalisations; 4.32 vs 2.22 hospital day visits; 14.63 vs 8.31 OP visits). Direct costs were also significantly higher for the comorbidity group (Table). In the moderate to severe pts, employees with comorbidities (N = 1849) vs those without (N = 1956) had significantly higher medical resource usage (0.46 vs 0.22 ED visits; 0.48 vs 0.27 overnight hospitalisations; 5.11 vs 2.81 hospital day visits; 16.62 vs 9.37 OP visits) and greater direct costs (Table).
|Average annual direct healthcare costs|
|All employees with UC||Employees with moderate/severe UC|
|With co-morbidity||No co-morbidity||P-Value||With co-morbidity||No co-morbidity||P-value|
|Hospital day visits||$4,448||$2,183||<0.0001b||$5,043||$2,726||<0.0001b|
|Adjusted total direct||$23,386||$13,242||<0.0001c||$27,775||$17,061||<0.0001c|
|aAmbulance and durable medical equipment services. bWilcoxon rank sum test. cGeneralised linear regression model.|
Employed UC pts with comorbidities had greater use of medical resources and higher medical costs, especially in moderate to severe UC. Treatment strategies for pts with UC should take into account comorbidities.