P793 The cost burden of Crohn’s disease and ulcerative colitis dependent on biologic treatment status – a register-based Danish population study from 2003 to 2015
S. Alulis1, K. Vadstrup*1, A. Borsi2, N. Gustafsson3, T. R. Jørgensen4, P. Munkholm5, N. Qvist6
1Janssen Immunology, Birkerød, Denmark, 2Janssen Immunology, High Wycombe, UK, 3Incentive, Holte, Denmark, 4Leo Pharma, Ballerup, Denmark, 5North Zealand University Hospital, Frederikssund, Denmark, 6Odense University Hospital, Odense, Denmark
Patients diagnosed with inflammatory bowel disease (IBD) may be put on biological treatment after diagnosis, depending on several medical and non-medical factors. This study investigated the average annual healthcare costs and production values of patients 10 years before and 8 years after diagnosis, and after initiating biologic treatment.
Incident CD and UC patients, aged 18 or more at diagnosis, in the period 2003–2015, were identified using the Danish National Patient Register. Average annual costs and production values of patients receiving biologic treatment after diagnosis were compared with patients who did not receive biologic treatment after diagnosis. Comparisons were also made between patients that initiated biologic treatment within the first year after diagnosis with those initiating treatment more than a year after diagnosis. Individual production values were estimated by multiplying the yearly employment rate with gender-specific gross average yearly wages, adjusted for the number of weekly working hours. Production values were estimated using 2016 wage indices. Linear regression models, adjusted for age and gender, accounted for differences in average annual costs and production value, per individual, between patients receiving or not receiving biologic treatment.
A total of 9019 CD and 20913 UC patients were included. Of these, 2351 (26.1%) CD and 2248 (10.7%) UC patients received biologic treatment at some point in the study period. The first year after diagnosis, 1091 CD patients initiated biologic treatment whereas 1260 initiated treatment more than a year after diagnosis. A total of 1022 UC patients started treatment within the first year after diagnosis and 1226 initiated treatment more than a year after diagnosis. Average annual production values of CD patients receiving biologic treatment the first year after diagnosis were lower before and after treatment initiation, compared with patients receiving treatment more than a year after diagnosis. UC patients receiving biologic treatment the first year after diagnosis had lower average annual production values the first year after treatment initiation compared with UC patients receiving treatment more than a year after diagnosis.
This study is not free from bias. It showed that patients receiving biologic treatment had higher average annual healthcare costs and lower average annual production values, compared with patients not receiving biologic treatment. This implies that patients treated with biologics are more severely affected compared with those not treated. Stratifying patients based on disease severity is warranted, however it was not undertaken in this analysis.