Abstract
BackgroundUlcerative colitis (UC) is an inflammatory bowel disease with increasing prevalence worldwide. Current treatment strategies place considerable economic and humanistic burdens on patients. The aim of this study was to determine the socioeconomic burden of UC in adult patients in European countries in a real-world setting.MethodsIn this retrospective, cross-sectional and observational pan-European study, patients with moderate or severe UC were assigned to ARM 1 and patients who had moderate or severe UC but achieved mild or remission status 12 months before index date (or clinical consultation date), were assigned to ARM 2. Clinical and medical resource use data were collected via electronic case report forms, and data on non-medical and indirect costs, and health-related quality of life (HRQoL) were collected via patient and public involvement and engagement (PPIE) questionnaires. Per-patient annual total costs per ARM and per country were calculated using the collated resource use in the last 12 months (between the start of the documentation period and patient consultation or index date) and country specific unit costs. Quality of life was described by arm and by country.ResultsIn the physician-reported eCRF population (n = 2966), the mean annual direct medical cost was €4065 in ARM 1 (n = 1835) and €2935 in ARM 2 (n = 1131). In the PPIE population (ARM 1, n = 1001; ARM 2, n = 647), mean annual direct cost was €4526 in ARM 1 and €3057 in ARM 2, mean annual direct non-medical cost was €1162 in ARM 1 and €1002 in ARM 2, mean annual indirect cost was €3098 in ARM 1 and €2309 ARM 2, and mean annual total cost was in €8787 in ARM 1 and €6368 in ARM 2. HRQoL scores showed moderate to high burden of UC in both groups.ConclusionsThe cost and HRQoL burden were high in patients in both ARM 1 and ARM 2 indicating unmet needs in the UC active population.
Highlights
Ulcerative colitis (UC) is an inflammatory bowel disease with increasing prevalence worldwide
Ulcerative colitis (UC) is a chronic, relapsing and remitting and potentially progressive form of inflammatory bowel disease (IBD) of uncertain aetiology, characterised by inflammation localised in the mucosa of the rectum and colon [1,2,3]
The primary objective of this study was to explore and quantify the annual costs of living with active UC from a societal perspective, and the secondary objective was to explore the effect of UC on the health-related quality of life (HRQoL) and productivity using patient-reported outcomes measurements (PROMs) and work-related activity
Summary
Ulcerative colitis (UC) is an inflammatory bowel disease with increasing prevalence worldwide. (EIM) in other tissues and organs, including the skin, joints, eyes, mouth, liver and lungs [4, 5]. It has an estimated incidence of 1.2–20.3 per 100,000 and a prevalence of 7.6–245 per 100,000 [6,7,8,9,10]. Current UC treatment strategies include medications that aim to induce and maintain clinical remission, prevent complications (such as hospitalisation, surgery, colorectal cancer and EIM) and improve health-related quality of life (HRQoL) [4, 11]. Treatment options are usually dictated by severity of disease and patient preference. Despite an expanding armamentarium of therapeutic options, the fluctuating course of UC and often unpredictable response to treatment implies that patients often experience disease “flares” requiring urgent out-patient consultations, hospitalisation and surgery for symptoms driven by refractory inflammation, complications of disease and hitherto under-recognised morbidity from chronic pain and psychosomatic issues [12,13,14,15,16,17,18]
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