Health Care Expenditure for Ulcerative Colitis Adult Patients for the Years 2007 to 2009: A Nationwide Estimate using Medical Expenditure Panel Survey

Abstract

Purpose: Ulcerative colitis is a chronic disease characterized by periods of increased disease activity that may require outpatient visits, inpatient hospitalizations and expensive medications. To quantify the direct medical expenditure associated with ulcerative colitis (UC) in United States using the Medical Expenditure Panel Survey (MEPS). Methods: MEPS is a nationally representative longitudinal survey conducted by Agency for Healthcare Research and Quality and National Center for Health Statistics. The Household component of MEPS (MEPS-HC) collects detailed information at the person and household level on health care utilization, expenditures, health insurance and health status for U.S civilian noninstitutionalized population. Patients with ulcerative colitis were identified in MEPS using ICD-9-CM code: 556.X. Nationally representative estimates of health care expenditure for UC patients were obtained from weighted MEPS data. In addition, the expenditure of UC patients for years 2007 to 2009 was combined to improve statistical precision of estimates. All expenditure estimates prior to 2009 were inflation adjusted using the Personal Health Care Expenditure Price Index (PHCE) and results were expressed in 2009 dollars. Results: The mean age of UC patients was 46.2 years (95% CI 42.87 to 49.59) and 48.3% were male; 88.3% were white and 6.7% were black. Of all UC patients, 8.3% were smokers. For the years 2007 to 2009, the average annual expenditure per UC patient was $8,801.32 (95%CI: $7718.29 to $9884.36). The highest proportion of cost for UC patients (32.5%) was related to pharmacy expenditure: $2,859.27 (95%CI: $2692.28 to $3026.25). The total outpatient expenditure excluding prescription costs comprised 42.3% of total expenditure as compared to only 8.5% of inpatient expenditure. Conclusion: The MEPS-HC data for the years 2007-2009 indicate that the largest proportion of health-care expenditure for UC patients is related to prescriptions and is 4 times higher than attributed to inpatient expenditure.