PGI57 NON-BIOLOGIC TREATMENT OF GERMAN PATIENTS WITH INFLAMMATORY BOWEL DISEASE: ASSESSMENT OF HEALTH CARE RESOURCE USE AND COST ASSOCIATED WITH DISEASE ACTIVITY

Abstract

Inflammatory bowel disease (IBD) describes chronic inflammatory disorders, with Crohn’s disease (CD) and ulcerative colitis (UC) as the most common forms. The majority of patients with at least moderate disease severity receives non-biologic therapies, mainly corticosteroids (CS) and/or immunosuppressants (IS). The aim of this study was to assess the percentage of non-biologic moderate/severe IBD patients with remaining IBD disease activity, and to understand the influence of observed active disease on health care resource use (HCRU) and direct cost. German claims data (AOK PLUS and GWQ ServicePlus; 8.5 million insured persons) were analysed retrospectively. CD/UC patients with at least one CS/IS prescription between 07/01/2015-06/30/2016 were included and followed for 12 months after index prescription. Indicators of IBD disease activity were (i) ≥2 prescriptions of systemic/locally-acting oral CS and/or (ii) at least one IBD-related surgery and/or (iii) IBD-related hospitalization(s) with ≥7 days of stay. In- and outpatient services as well as medication were considered for HCRU / cost analysis, numbers were reported per patient year (PY). Of 5,170 CD (mean age 48.2 years, 56.9% female) and 4,701 UC patients (55.0 years, 48.5% female), 2,433 CD patients (50.3 years, 55.3% female) and 1,940 UC patients (58.2 years, 48.6%) had remaining IBD disease activity. Patients with active disease more often visited a GP than patients with non-active disease (6.8 vs. 6.1; 5.9 vs. 5.7 visits; p<0.001), had a higher frequency of specialist visits in case of CD (7.7 vs. 6.9, p<0.001) and experienced higher IBD-associated hospitalization rates (0.6 vs. 0.2, 0.3 vs. 0.2, p<0001). Direct IBD-associated costs for CD/UC patients with/without disease activity were 9,047€ vs. 4,049€ (p<0.001) and 8,655€ vs. 4,708€ (p<0.001). A substantial percentage of moderate to severe non-biologic IBD patients shows remaining disease activity which is itself associated with a substantial increase in HCRU and cost.