PRESCRIPTION PATTERN AND COST OF ILLNESS (COI) OF INFLAMMATORY BOWEL DISEASE (IBD) IN A TERTIARY CARE HOSPITAL

Mirza Misba Ali Baig,Syed Amir Ali,Md Nomaan Ilyas,Shaheda Siddiqui,Sara Fatima,Mehruq Fatima

doi:10.22159/ijpps.2017v9i1.14248

Mirza Misba Ali Baig, Syed Amir Ali + Show 4 more

Open Access

https://doi.org/10.22159/ijpps.2017v9i1.14248

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Abstract

Objective: Treatment of Inflammatory Bowel disease (IBD) centers on agents used to relieve inflammatory process. None of the drugs used for IBD are curative; at best they serve to control the disease process. The potentially high costs of care associated with inflammatory bowel disease (IBD) are recognised. The Objective of the present study was to find the Prescription pattern and cost of illness (COI) of IBD in a Tertiary care Hospital.Methods: 20 IBD patients, in the order they approached the gastroenterology department, were enrolled in the study. Data regarding medication, hospitalisation, physician office visit, diagnostic costs, travel cost, the cost incurred by caregivers, work and non-work days lost were obtained. The cost of medications and other healthcare services was determined. The study was approved by the Institutional ethics committee. Results: The average cost (direct and indirect) per patient for six months was 26,394Rs. Drugs and medical supplies costs (65%) ranked first in the direct costs category followed by Diagnostic costs (18%), hospitalisation costs (15%) and lastly physician office visit costs (2%). On the other hand, Cost incurred by caregivers accounted for 45% of the total indirect costs followed by work and nonworking days lost (43%) and finally Travel costs (2%). Commonly prescribed drugs were corticosteroids and aminosalicylates followed by mucosal protectants, antibiotics and antiemetics. The most preferred route of drug administration was intravenous followed by oral. Conclusion: The average COI (direct and indirect) of IBD per patient for six months was 26,394Rs. Drugs and medical supplies accounted for largest contributions to the overall economic impact of IBD on the Healthcare system. Commonly prescribed drugs were corticosteroids and aminosalicylates followed by mucosal protectants, antibiotics and antiemetics. This study represents one of the very few studies conducted on COI of IBD. Large scale studies on economic research are required to further ascertain the impact of Rival therapies and management strategies for IBD.

Highlights

Inflammatory Bowel disease (IBD) comprises of Ulcerative Colitis, Crohn’s Disease and Indeterminate colitis
On the basis of the diagnosis, total patients were categorised into two groups-Ulcerative Colitis and Crohn’s Disease with percentage population of 95 and 5 respectively
The majority of the patients (84.2%) with ulcerative colitis were treated with corticosteroid in combination with 5-aminosalicylic acid

Summary

Introduction

Inflammatory Bowel disease (IBD) comprises of Ulcerative Colitis, Crohn’s Disease and Indeterminate colitis. It is the chronic, idiopathic, immune mediated, relapsing, inflammatory condition of the gastrointestinal tract [1, 2]. Standard medical therapy includes corticosteroid in the acute phase, mesalazine or immunomodulators to maintain remission and biological agents for refractory and/or severe cases [3]. Hospitalization and surgery contribute to more than half of the economic burden of IBD to the society [4,5,6,7]. The quality of life of the patient is severely compensated with continuing symptoms, reduction in the ability to work, social stigma, bathroom access issues, difficulty with physical intimacy and restriction in career choices [8]

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