Abstract

Abstract Background The incidence and prevalence of inflammatory bowel disease (IBD) has increased significantly in the last decade in Mexico. This work describes the burden of disease in terms of healthcare resources utilization and costs (direct and indirect) related to the management of patients (pts) diagnosed with moderate/severe ulcerative colitis (UC) and Crohn’s disease (CD), over 3 years. Methods This multicenter, retrospective, non-interventional study enrolled 335 IBD pts. Upon written consent for eligible pts, data regarding disease activity, treatment patterns and burden of disease were collected (Fig 1). Direct costs calculation was obtained by a micro-cost analysis and cross-sectional indirect costs (human capital/income) by proportional hours of absence/productivity, based on Work Productivity and Activity Impairment score. Unitary costs were taken from institutional data: Groups Related to the Diagnosis (GRD-IMSS) 2017 updated with the INEGI explosion factor in the middle of the year 2022 and IMSS Unit Costs 2022, the price of the drugs used was from the Annual Acquisitions, Leasing and Services Program updated to September 2022. Direct costs were obtained by multiplying resource use with relevant unit costs. Unit costs for each resource items were collected in Mexican reliable administrative databases or other sources. All data were descriptively analyzed. Results There were 335 pts enrolled and 326 eligible. 95 (29.1%) had CD and 231 (70.9%) had UC. In the CD group, 52 pts had remission/mild activity and 43 had moderate/severe activity. A total of 26.3% (25/95) disease–related hospitalizations were reported in CD pts and 15.6% (36/231) for UC pts. The mean of hospitalization duration was 11.7 days for pts with moderate/severe CD and 8.5 days for pts with moderate/severe UC. The absenteeism in CD pts was 19.9% for moderate/severe and 17.3% for remission/mild activity, while in UC pts was 9.8% for moderate/severe and 10.6% for remission/mild activity. Considering comorbidities, extraintestinal manifestations, previous treatments, medical appointments, hospitalizations and other medical procedures, the annual direct costs per-patient impact in CD was US$19,026 (moderate/severe) and US$12,126 (remission/mild). Furthermore, in pts with UC, the cost was US$11,516 (moderate/severe) and US$8,952 (remission/mild). The indirect costs represent US$1,191 for CD and US$376 for UC (Fig 1F). Conclusion The disability rate of CD is 25% [20-34%], this study reports 18.4%. CD was associated with higher rates of hospitalization and increase in cost of health care resources, compared to UC patients.

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