The burden of selected digestive diseases in the United States.
OBJECTIVE
Gastrointestinal (GI) and liver diseases inflict a heavy economic burden. Although the burden is considerable, current and accessible information on the prevalence, morbidity, and cost is sparse. This study was undertaken to estimate the economic burden of GI and liver disease in the United States for use by policy makers, health care providers, and the public.


METHODS
Data were extracted from a number of publicly available and proprietary national databases to determine the prevalence, direct costs, and indirect costs for 17 selected GI and liver diseases. Indirect cost calculations were purposefully very conservative. These costs were compared with National Institutes of Health (NIH) research expenditures for selected GI and liver diseases.


RESULTS
The most prevalent diseases were non-food-borne gastroenteritis (135 million cases/year), food-borne illness (76 million), gastroesophageal reflux disease (GERD; 19 million), and irritable bowel syndrome (IBS; 15 million). The disease with the highest annual direct costs in the United States was GERD ($9.3 billion), followed by gallbladder disease ($5.8 billion), colorectal cancer ($4.8 billion), and peptic ulcer disease ($3.1 billion). The estimated direct costs for these 17 diseases in 1998 dollars were $36.0 billion, with estimated indirect costs of $22.8 billion. The estimated direct costs for all digestive diseases were $85.5 billion. Total NIH research expenditures were $676 million in 2000.


CONCLUSIONS
GI and liver diseases exact heavy economic and social costs in the United States. Understanding the prevalence and costs of these diseases is important to help set priorities to reduce the burden of illness.
Sandler
Robert S
RS
University of North Carolina, Chapel Hill, North Carolina 27599-7080, USA. rsandler@med.unc.edu
Everhart
James E
JE
Donowitz
Mark
M
Adams
Elizabeth
E
Cronin
Kelly
K
Goodman
Clifford
C
Gemmen
Eric
E
Shah
Shefali
S
Avdic
Aida
A
Rubin
Robert
R
D017281:Cost of Illness; D005767:Gastrointestinal Diseases / Q000191:economics* / Q000401:mortality; D005102:Health Expenditures; D006801:Humans; D008107:Liver Diseases / Q000191:economics* / Q000401:mortality; D014481:United States