title: Health Care Cost Analysis in a Population-based Inception Cohort of Inflammatory Bowel Disease Patients in the First Year of Diagnosis.
abstract: BACKGROUND
  There are limited prospective population-based data on the health care cost of IBD in the post-biologicals era. A prospective registry that included all incident cases of inflammatory bowel disease [IBD] was established to study disease progress and health cost.
  
  
  OBJECTIVE
  To prospectively assess health care costs in the first year of diagnosis among a well-characterised cohort of newly diagnosed IBD patients.
  
  
  METHODS
  Incident cases of IBD were prospectively identified in 2007-2008 and 2010-2013 from multiple health care providers, and enrolled into the population-based registry. Health care resource utilisation for each patient was collected through active surveillance of case notes and investigations including specialist visits, diagnostic tests, medications, medical hospitalisation, and surgery.
  
  
  RESULTS
  Off 276 incident cases of IBD, 252 [91%] were recruited to the registry, and health care cost was calculated for 242 (146 Crohn's disease [CD] and 96 ulcerative colitis [UC] patients). The median cost in CD was higher at A$5905 per patient (interquartile range [IQR]: A$1571-$91,324) than in UC at A$4752 [IQR: A$1488-A$58,072]. In CD, outpatient resources made up 55% of all cost, with medications accounting for 32% of total cost [15% aminosalicylates, 15% biological therapy], followed by surgery [31%], and diagnostic testing [21%]. In UC, medications accounted for 39% of total cost [of which 37% was due to 5-aminosalicylates, and diagnostics 29%; outpatient cost contributed 71% to total cost.
  
  
  CONCLUSIONS
  In the first year of diagnosis, outpatient resources account for the majority of cost in both CD and UC. Medications are the main cost driver in IBD.
authors.affiliation: Gastroenterology Department, St Vincent's Hospital, Melbourne, VIC, Australia ola.niewiadomski@svhm.org.au.
authors.forename: Olga
authors.initials: O
authors.lastname: Niewiadomski
authors.affiliation: Gastroenterology Department, Royal Hobart Hospital, Hobart, TAS, Australia.
authors.forename: Corrie
authors.initials: C
authors.lastname: Studd
authors.affiliation: Gastroenterology Department, University Hospital Geelong, Barwon Health, Geelong, VIC, Australia.
authors.forename: Christopher
authors.initials: C
authors.lastname: Hair
authors.affiliation: Gastroenterology Department, Royal Hobart Hospital, Hobart, TAS, Australia.
authors.forename: Jarrad
authors.initials: J
authors.lastname: Wilson
authors.affiliation: Department of Epidemiology & Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC, Australia.
authors.forename: John
authors.initials: J
authors.lastname: McNeill
authors.affiliation: Gastroenterology Department, University Hospital Geelong, Barwon Health, Geelong, VIC, Australia.
authors.forename: Ross
authors.initials: R
authors.lastname: Knight
authors.affiliation: Gastroenterology Department, University Hospital Geelong, Barwon Health, Geelong, VIC, Australia.
authors.forename: Emily
authors.initials: E
authors.lastname: Prewett
authors.affiliation: Gastroenterology Department, University Hospital Geelong, Barwon Health, Geelong, VIC, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Dabkowski
authors.affiliation: Gastroenterology Department, University Hospital Geelong, Barwon Health, Geelong, VIC, Australia.
authors.forename: Damian
authors.initials: D
authors.lastname: Dowling
authors.affiliation: Gastroenterology Department, University Hospital Geelong, Barwon Health, Geelong, VIC, Australia.
authors.forename: Sina
authors.initials: S
authors.lastname: Alexander
authors.affiliation: Gastroenterology Department, University Hospital Geelong, Barwon Health, Geelong, VIC, Australia.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Allen
authors.affiliation: Melbourne EpiCentre and Northern Clinical Research Centre, Melbourne Health, Melbourne, VIC, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Tacey
authors.affiliation: Gastroenterology Department, St Vincent's Hospital, Melbourne, VIC, Australia.
authors.forename: William
authors.initials: W
authors.lastname: Connell
authors.affiliation: Gastroenterology Department, St Vincent's Hospital, Melbourne, VIC, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Desmond
authors.affiliation: Gastroenterology Department, St Vincent's Hospital, Melbourne, VIC, Australia.
authors.forename: Sally
authors.initials: S
authors.lastname: Bell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000191:economics; D000893:Anti-Inflammatory Agents / Q000191:economics / Q000627:therapeutic use; D002648:Child; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D005765:Gastrointestinal Agents / Q000191:economics / Q000627:therapeutic use; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007166:Immunosuppressive Agents / Q000191:economics / Q000627:therapeutic use; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis / Q000191:economics* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries; D014739:Victoria; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D005765:Gastrointestinal Agents; D007166:Immunosuppressive Agents
keywords: Crohn’s disease; Inflammatory bowel disease; health cost analysis; population-based; ulcerative colitis