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P566 The cost for IBD care during the first 5 years after diagnosis

D. Sjöberg*1, U. Karlbom2, M. Thörn3, D. Fawunmi4, A. Rönnblom3

1Centre of Clinical Research, Falun, Sweden, 2Uppsala University Hospital, Department of Surgical Sciences, Uppsala, Sweden, 3Uppsala University Hospital, Department of Gastroenterology, Uppsala, Sweden, 4Mälarsjukhuset, Medical clinic, Eskilstuna, Sweden

Background

Detailed studies regarding healthcare costs for IBD only exists for the first 2 years after diagnosis, when comparing contemporary treatment. Previous studies report that the first year tend to have very high costs, whereas the cost decreases rapidly the following years. The introduction of biological treatments has caused concern that this pattern will change. In combination with an increased incidence of IBD, this highlights important questions regarding financial resources allocation to IBD care.

Methods

Patients diagnosed with IBD during the years 2005–2009 in the Uppsala region of Sweden (the ICURE cohort) were included in a healthcare economic study, aimed to describe the direct cost of IBD care. All medical records were analysed with regards to inpatient and outpatient care, pharmacological treatment, endoscopy and radiology during the first 5 years after diagnosis. All costs were recalculated according to the prize level of 2017. Values in SEK were converted to EUR at a ratio of 1:0.097.

Results

A total of 548 patients (UC: n = 363); CD: n = 185) participated in the study. The total cost for year 1–5 was 11 230 EUR for UC and 21 550 EUR for CD (p < 0.001).

Total cost year 1–5.

The cost was estimated to 5 070 EUR during the first year of disease for UC and 11 790 EUR for CD (p < 0.001). During year 2–5 the cost decreased to 1 500 EUR/year for UC and 2 240 EUR/year for CD.

Yearly cost.

Pharmacological treatment was 22% of total cost. There was no significant difference between men and women, but children (<17 years) had more expensive outpatient care (UC and CD) and inpatient care (CD) compared with adults. Patients in need of surgery had significantly higher costs each of the 5 years during follow-up.

Conclusion

The earlier reported pattern with high cost during the first year and rapidly decreasing costs during the following years seems to continue. Surgical treatment of IBD is the dominating cause of high costs, despite the introduction of biological treatments. Admission to an inpatient ward for IBD is mainly due to surgical treatment, but there are also high costs that can be attributed to non-surgical inpatient care. With the introduction of anti-TNF biosimilars, pharmacological costs can be reduced unless a larger percentage of the patients are treated with biological drugs.