title: Inflammatory Bowel Diseases (Crohn´s Disease and Ulcerative Colitis): Cost of Treatment in Serbia and the Implications.
abstract: BACKGROUND
  Although the costs of treating inflammatory bowel disease (IBD) in developed countries are well established, they remain largely unknown in countries with recent histories of socio-economic transition including Serbia.
  
  
  OBJECTIVE
  To estimate the costs of treatment including the resources used by patients with IBD in Serbia from a societal perspective. This includes both Crohn's disease and ulcerative colitis.
  
  
  METHODS
  This cost-of-illness study was conducted to identify direct, indirect and out-of-pocket costs of treating patients with IBD in Serbia. Patients with IBD (n = 112) completed a semi-structured questionnaire with data concerning their utilisation of heath-care resources and illness-related expenditures. All costs were calculated in Republic of Serbia dinars (RSD) at a 1-year level (2014) and subsequently converted to Euros. Median values and ranges were reported to avoid potential distortions associated with mean costs.
  
  
  RESULTS
  Median total direct costs and total indirect costs per patient per year in patients with Crohn's disease were 192,614.32RSD (€1602.97) and 28,014.00RSD (€233.13) and 142,267.15RSD (€1183.97) and 21,436.00RSD (€178.39), respectively, in patients with ulcerative colitis. In both groups, the greatest component of direct costs was hospitalisation.
  
  
  CONCLUSIONS
  Costs of IBD in Serbia are lower than in more developed countries for two reasons. These include the fact that expensive biological therapy is currently under-utilised in Serbia and prices of health services are largely controlled by the State at a low level. The under-utilisation of biologicals may change with the advent of biosimilars at increasingly lower prices.
authors: Department of Pharmacology and Toxicology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.
authors: Marina
authors: M
authors: Kostić
authors: Association of patients with Crohn's disease and Ulcerative colitis, Belgrade, Serbia.
authors: Ljiljan
authors: L
authors: Djakovic
authors: Association of patients with Crohn's disease and Ulcerative colitis, Belgrade, Serbia.
authors: Raša
authors: R
authors: Šujić
authors: Division of Clinical Pharmacology, Karolinska Institute, Karolinska University Hospital Huddinge, 141 86, Stockholm, Sweden. Brian.Godman@ki.se.|Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, G4 0RE, UK. Brian.Godman@ki.se.|Liverpool Health Economics Centre, Liverpool University, Liverpool, UK. Brian.Godman@ki.se.
authors: Brian
authors: B
authors: Godman
authors: Department of Pharmacology and Toxicology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.
authors: Slobodan M
authors: SM
authors: Janković
mesh_terms: D000293:Adolescent; D000328:Adult; D003093:Colitis, Ulcerative / Q000191:economics* / Q000628:therapy; D003424:Crohn Disease / Q000191:economics* / Q000628:therapy; D003695:Delivery of Health Care / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D005382:Financing, Personal / Q000191:economics / Q000706:statistics & numerical data; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D055771:Serbia; D011795:Surveys and Questionnaires; D055815:Young Adult