The Direct and Indirect Cost Burden of Illness of Ulcerative Colitis

Abstract

Purpose: To estimate the direct medical costs and indirect costs (productivity related) for commercially-insured patients with Ulcerative Colitis. Methods: Data were obtained from the 1999 to 2005 MarketScan Commercial Claims and Encounters (CCAE), Medicare Supplemental, and Health and Productivity Management databases. Patients with a diagnosis of Ulcerative Colitis and at least a 1-year disease-free pre-period were found resulting in 8,970 nonelderly patients with Ulcerative Colitis and 2,958 elderly patients with Ulcerative Colitis. 12-month direct medical care expenditures (medical and prescription drug) for patients with Ulcerative Colitis were compared to expenditures among an equal number of propensity-score matched comparison group members. Propensity scores were estimated via demographic characteristics and comorbidities. Indirect costs, as measured by absenteeism and short-term disability costs, were compared for a sub-sample of employees in each group. Regression analysis controlled for demographic and case mix factors. A range of cost burden estimates were produced by varying the estimation and matching techniques. Results: Average 12-month direct medical care expenditures were $4,982 for nonelderly and $8,572 for elderly comparison group members. Average estimated direct medical expenditures for patients with Ulcerative Colitis exceeded comparison group members by as much as $11,331 for nonelderly patients and $6,609 for elderly patients (all P < .01). Average absenteeism costs were $6,021 for employees with Ulcerative Colitis, although this was not significantly different from the comparison group. Average short term disability expenditures were $1,386, which was almost three times the amount for the comparison group (P < .05). Conclusion: Ulcerative Colitis is a costly disorder and merits consideration as interventions are developed to manage the burden of disease and improve productivity.