title: Medical resource utilization and associated costs in patients with ulcerative colitis in the UK: a chart review analysis.
abstract: OBJECTIVE
  Limited evidence is available on the economic burden of ulcerative colitis (UC) in the UK, particularly relating to the impact of relapse frequency on direct medical costs. This study identifies and assesses medical resource utilization (MRU) and associated direct costs in mild and moderate UC patients in the UK.
  
  
  METHODS
  A retrospective chart review of patients with mild-to-moderate UC diagnosed at least 1 year before the study was performed. From 33 general practitioner (GP) and 34 gastroenterologist sites, charts of the last three UC patients fulfilling the inclusion criteria were reviewed. Descriptive statistics were calculated for MRU and 2011 costs (GB£) by number of relapses.
  
  
  RESULTS
  The study population included 201 patients with a mean age of 39.9 years; 44% were women and the mean disease duration was 7.4 years. UC-related costs of each MRU category increased with the number of relapses. Comparing patients without relapse with those with more than two relapses, the mean annual UC-related costs were £14 versus £2556 for hospitalizations; £218 versus £988 for visits (including nurse, GP, specialist, and other visits); £21 versus £1303 for procedures; £17 versus £188 for diagnostics; and £1168 versus £6660 for all-cause total costs. Age, sex, and site of data reporting (GP vs. gastroenterologist) were not associated with MRU or costs.
  
  
  CONCLUSIONS
  Patients with mild-to-moderate UC incurred considerable costs that increased markedly with the number of relapses. These findings support the importance of maintenance therapies in UC that reduce or prevent relapses. Quantifying the relationship between relapse rate and costs will inform future health economic studies.
authors.affiliation: aGastroenterology Department, Digestive Diseases Centre, Aintree University Hospital, Institute of Translational Medicine, University of Liverpool, Liverpool bCovance, Leeds, UK cShire, Wayne, Pennsylvania dCovance, Gaithersburg, Maryland, USA.
authors.forename: Keith
authors.initials: K
authors.lastname: Bodger
authors.forename: Linnette
authors.initials: L
authors.lastname: Yen
authors.forename: Agota
authors.initials: A
authors.lastname: Szende
authors.forename: Gunjan
authors.initials: G
authors.lastname: Sharma
authors.forename: Yaozhu J
authors.initials: YJ
authors.lastname: Chen
authors.forename: John
authors.initials: J
authors.lastname: McDermott
authors.forename: Paul
authors.initials: P
authors.lastname: Hodgkins
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000191:economics* / Q000628:therapy*; D003365:Costs and Cost Analysis; D003938:Diagnostic Techniques, Digestive System / Q000191:economics; D005260:Female; D017048:Health Care Costs; D006295:Health Resources / Q000191:economics* / Q000706:statistics & numerical data; D017721:Hospital Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D015999:Multivariate Analysis; D009819:Office Visits / Q000191:economics; D012008:Recurrence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D006113:United Kingdom; D055815:Young Adult