The Economic and Quality-of-Life Burden of Crohn’s Disease in Europe and the United States, 2000 to 2013: A Systematic Review

Abstract

Background

Crohn’s disease (CD) is associated with a substantial healthcare burden that affects the patient, healthcare systems and society in general.

Aim

To provide a systematic evaluation of published data relating to the economic and health-related quality-of-life (HRQoL) burden of CD in selected European countries (Germany, France, UK, Italy, Spain) and the USA since 2000.

Methods

We undertook a systematic review of publications relating to CD, its economic burden and impact on HRQoL. Research questions focused on the disease costs from a societal perspective and HRQoL burden in adults and pediatric/adolescent patients according to disease stage/severity. Total, direct and indirect costs were identified, as well as the impact of CD on HRQoL measured using both generic and disease-specific instruments.

Results

Overall, 61 publications met the research criteria (38 on costs, 23 on HRQoL). CD in the USA and Europe together was associated with annual total costs of nearly €30 billion, more than half due to indirect costs. HRQoL was consistently and statistically significantly lower among CD patients compared with normal populations, due to physical, emotional and social effects.

Conclusions

CD is a global health problem with high societal costs and substantial HRQoL burden. High-value care pathways including cost-effective therapies will help to induce and maintain remission, reduce complications of disease and improve HRQoL.

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Conflict of interest

DF: employed by PHMR: PHMR received an unrestricted grant from Nestlé Health Science S.A. to perform the systematic literature search. SL: employed by PHMR: PHMR received an unrestricted grant from Nestlé Health Science S.A. to perform the systematic literature search. HS: previous employee of Nestle Health Sciences. BGL: Received consulting fees from Prometheus Labs, Santarus Inc., and Nestle Health Sciences, Abbvie and Takeda.

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Correspondence to Barrett G. Levesque.

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Floyd, D.N., Langham, S., Séverac, H.C. et al. The Economic and Quality-of-Life Burden of Crohn’s Disease in Europe and the United States, 2000 to 2013: A Systematic Review. Dig Dis Sci 60, 299–312 (2015). https://doi.org/10.1007/s10620-014-3368-z

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Keywords

  • Crohn’s disease
  • Epidemiology
  • Prevalence
  • Incidence
  • Cost burden
  • Quality of life
  • Quality-of-life burden