title: Novel Testing Enhances Irritable Bowel Syndrome Medical Management: The IMMINENT Study.
abstract: OBJECTIVE
  To evaluate the economic utility of a fecal biomarker panel structured to suggest alternative, treatable diagnoses in patients with symptoms of irritable bowel syndrome (IBS) by quantifying, comparing, and contrasting health service costs between tested and non-tested patients.
  
  
  METHODS
  Retrospective, matched cohort study comparing direct medical costs for IBS patients undergoing fecal biomarker testing with those of matched control subjects.
  
  
  METHODS
  We examined de-identified medical and pharmacy claims of a large American pharmacy benefit manager to identify plan members who underwent panel testing, were eligible for covered benefits for at least 180 days prior to the test date, and had data available for 30, 90, and 365 days after that date. We used propensity score matching to develop population-based control cohorts for each tested cohort, comprised of records with IBS-related diagnoses but for which panel testing was not performed. Primary outcome measures were diagnostic and medical services costs as determined from claims data.
  
  
  RESULTS
  Two hundred nine records from tested subjects met inclusion criteria. The only significant baseline differences between groups were laboratory costs, which were significantly higher in each tested cohort. At each follow-up time point, total medical and gastrointestinal procedural costs were significantly higher in non-tested cohorts. Within tested cohorts, costs declined significantly from baseline, while costs rose significantly in non-tested control cohorts; these differences were also significant between groups at each time point.
  
  
  CONCLUSIONS
  Structured fecal biomarker panel testing was associated with significantly lower medical and gastrointestinal procedural costs in this study of patients with IBS symptoms.
authors.affiliation: Express Scripts, St Louis, Missouri (Dr Parsons), United States.
authors.forename: Kelly
authors.initials: K
authors.lastname: Parsons
authors.affiliation: Lupine Creative Consulting (Dr Goepp), United States.
authors.forename: Julius
authors.initials: J
authors.lastname: Goepp
authors.affiliation: Express Scripts, St Louis, Missouri (Dr Dechairo), United States.
authors.forename: Bryan
authors.initials: B
authors.lastname: Dechairo
authors.affiliation: Genova Diagnostics, Asheville, North Carolina (Dr Fowler), United States.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Fowler
authors.affiliation: Express Scripts, St Louis, Missouri (Dr Markward), United States.
authors.forename: Nathan
authors.initials: N
authors.lastname: Markward
authors.affiliation: Institute for Functional Medicine, Federal Way, Washington (Dr Hanaway), United States.
authors.forename: Patrick
authors.initials: P
authors.lastname: Hanaway
authors.affiliation: Genova Diagnostics, Asheville, North Carolina (Dr McBride), United States.
authors.forename: Teresa
authors.initials: T
authors.lastname: McBride
authors.affiliation: Genova Diagnostics, Asheville, North Carolina (Dr Landis), United States.
authors.forename: Darryl
authors.initials: D
authors.lastname: Landis
keywords: Irritable bowel syndrome (IBS); cohort study; fecal biomarker panel; medical management