title: Managing the long term care of inflammatory bowel disease patients: The cost to European health care providers.
abstract: OBJECTIVE
  Inflammatory Bowel Disease (which includes Crohn's Disease and Ulcerative Colitis), is a chronic condition characterised by substantial morbidity. Inflammatory Bowel Disease patients are considered expensive to manage, hence accurate estimates of care costs are crucial to help healthcare providers plan clinical management. The aim of this study is to estimate the cost of care for Crohn's Disease and Ulcerative Colitis patients in the United Kingdom and Western mainland Europe.
  
  
  METHODS
  Decision models were built to simulate the natural disease history of Crohn's Disease and Ulcerative Colitis, informed by United Kingdom and European clinical pathways. A healthcare provider perspective was adopted, model inputs were informed by published sources and expert opinion, and UK healthcare costs were used (2008 prices). Cohorts of 25 year old patients presenting with symptoms of varying severity were modelled over ten years, and annual treatment costs calculated per patient.
  
  
  RESULTS
  The average annual cost of care per Crohn's Disease/Ulcerative Colitis patient was £631/£762 (United Kingdom) and £838/£796 (Europe). Most costs were incurred immediately following diagnosis, particularly in European Crohn's patients, reflecting the earlier use of more aggressive treatments. Surgery, hospitalisation, and the use of biological therapies and mesalazine (in Ulcerative Colitis) were key cost drivers. The total annual cost to the United Kingdom National Health Service of caring for Inflammatory Bowel Disease patients was estimated to be £131million.
  
  
  CONCLUSIONS
  This study confirms that Inflammatory Bowel Disease patients are expensive to manage and illustrates the importance of differentiating between alternative clinical management scenarios.
authors.affiliation: Health Economics Research Centre, University of Oxford, Oxford, UK. james.buchanan@dphpc.ox.ac.uk
authors.forename: James
authors.initials: J
authors.lastname: Buchanan
authors.forename: Sarah
authors.initials: S
authors.lastname: Wordsworth
authors.forename: Tariq
authors.initials: T
authors.lastname: Ahmad
authors.forename: Angela
authors.initials: A
authors.lastname: Perrin
authors.forename: Severine
authors.initials: S
authors.lastname: Vermeire
authors.forename: Miquel
authors.initials: M
authors.lastname: Sans
authors.forename: Jenny
authors.initials: J
authors.lastname: Taylor
authors.forename: Derek
authors.initials: D
authors.lastname: Jewell
mesh_terms: D000328:Adult; D005060:Europe; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000191:economics* / Q000628:therapy; D018803:Models, Economic; D006113:United Kingdom