Disease activity, quality of life, and indirect costs of ulcerative colitis in Poland.
BACKGROUND
Ulcerative colitis (UC) require expensive, lifelong treatment, which generates huge direct costs and has a significant impact on the quality of life, especially in the active state of the disease.


OBJECTIVE
To assess the indirect costs, health-related quality of life, and clinical characteristics of patients with UC in Poland. Additionally, we investigated the association between activity of UC and productivity loss of patients in a Polish setting.


METHODS
A questionnaire survey was conducted using the Patient Simple Clinical Colitis Activity Index (P-SCCAI) to assess disease activity, as well as the modified Work Productivity and Activity Impairment Questionnaire to assess productivity loss. The quality of life was presented as utility calculated with the EQ-5D-3L questionnaire. Indirect costs were assessed with the Human Capital Approach and were expressed in Polish zlotys (PLN) as well as in euros (€). Correlations were presented using the Spearman coefficient.


RESULTS
We performed our analysis based on 202 full questionnaires collected. Mean patient age and age at disease onset were 33.14 years (standard deviation (SD): 9.90) and 26.35 years (SD: 8.89), respectively. The mean P-SCCAI score in the analysed group of patients was 8.26, and the mean utility was 0.8651. Average and median annual indirect costs per working person were €2043 and €1389 (8543 PLN and 5808 PLN), respectively, calculated using the gross domestic product, as well as €4791 and €3257 (20,026 PLN and 13,615 PLN), respectively, calculated using the gross value added. Total productivity loss was significantly correlated with the disease activity.


CONCLUSIONS
Ulcerative colitis causes a decrease in the quality of life as well as patients' productivity loss associated with both absenteeism and with presenteeism.
Drug Management Department, Institute of Public Health, Faculty of Health Sciences, Medical College Jagiellonian University, Krakow, Poland.
Paweł
P
Kawalec
StatSoft Polska Sp. z o.o., Krakow, Poland.
Ewa
E
Stawowczyk
Polish Association Supporting People with Inflammatory Bowel Disease "J-elita", Warsaw, Poland.
Małgorzata
M
Mossakowska
Department of Neurobiology, Institute of Pharmacology, Polish Academy of Sciences, Krakow, Poland.
Andrzej
A
Pilc
indirect costs; productivity loss; quality of life; ulcerative colitis