Digestive Diseases and Sciences

, Volume 57, Issue 12, pp 3080–3091

Direct Health Care Insurer and Out-of-Pocket Expenditures of Inflammatory Bowel Disease: Evidence from a US National Survey

Authors

  • Candace Gunnarsson
    • S2 Statistical Solutions, Inc.
  • Jie Chen
    • Department of Political Science, Economics, and Philosophy, College of Staten IslandCUNY
    • Department of Health Services Administration, School of Public HealthUniversity of Maryland
  • John A. Rizzo
    • Department of Preventive MedicineStony Brook University
    • Department of EconomicsStony Brook University
  • Joseph A. Ladapo
    • Harvard Medical School
    • Department of MedicineBeth Israel Deaconess Medical Center
    • Department of Population MedicineNew York University
    • Janssen Scientific Affairs, LLC
Original Article

DOI: 10.1007/s10620-012-2289-y

Cite this article as:
Gunnarsson, C., Chen, J., Rizzo, J.A. et al. Dig Dis Sci (2012) 57: 3080. doi:10.1007/s10620-012-2289-y

Abstract

Background

Crohn’s disease (CD) and ulcerative colitis (UC) are chronic, debilitating conditions that can have important economic and clinical implications.

Aim

To quantify individual and national estimates of the health care and patient out-of-pocket (OOP) costs of CD and UC.

Methods

In a retrospective study using 1996 to 2009 data from the Medical Expenditure Panel Survey, individuals’ self-reported health conditions were mapped to International Classification of Diseases, Ninth Revision, Clinical Modification diagnostic codes. Individuals with a code of 555.x (CD) or 556.x (UC) were identified. Health care services and costs included prescriptions and inpatient, outpatient, emergency room, office, and home health services. OOP costs were the portion of individuals’ total payments for health care services.

Results

There were 358 individuals with CD (mean age 49.0 years; 55 % female), 198 individuals with UC (mean age 47.1 years; 64 % female), and 206,993 individuals without inflammatory bowel disease (IBD) (mean age 48.2 years; 58 % female). Annual per capita health insurer and OOP costs for individuals with CD were greater than those without IBD ($9,526 versus $3,781, p < 0.001 and $1,603 versus $866, p < 0.001, respectively). Health insurer and OOP costs were greater for UC compared with those without IBD ($6,443 versus $3,781, p < 0.001 and $1,263 versus $866, p < 0.001, respectively). US national aggregate annual estimates of health insurer, OOP, and total direct costs secondary to CD are $2.04 billion, $0.26 billion, and $2.29 billion, respectively. Aggregate health insurer, OOP, and total direct costs attributable to UC are $0.53 billion, $0.07 billion, and $0.61 billion, respectively.

Conclusions

The direct costs associated with CD and UC are substantial. The extent to which appropriate diagnosis and treatment reduces the total health care costs for individuals with CD or UC should be examined.

Keywords

Costs and cost analysisCrohn’s diseaseHealth care costsHealth expendituresInflammatory bowel diseaseUlcerative colitis

Copyright information

© Springer Science+Business Media, LLC 2012