The Cost of Inflammatory Bowel Disease Management Matches with Clinical Course: A Single Outpatient Centre Analysis

Mariabeatrice Principi, Nunzia Labarile, Francesco Paolo Bianchi, Antonella Contaldo, Silvio Tafuri, Enzo Ierardi and Alfredo Di Leo
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Mariabeatrice Principi: Section of Gastroenterology, Department of Emergency and Organ Transplantation, University Aldo Moro of Bari, 70124 Bari, Italy
Nunzia Labarile: Section of Gastroenterology, Department of Emergency and Organ Transplantation, University Aldo Moro of Bari, 70124 Bari, Italy
Francesco Paolo Bianchi: Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, 70124 Bari, Italy
Antonella Contaldo: Section of Gastroenterology, Department of Emergency and Organ Transplantation, University Aldo Moro of Bari, 70124 Bari, Italy
Silvio Tafuri: Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, 70124 Bari, Italy
Enzo Ierardi: Section of Gastroenterology, Department of Emergency and Organ Transplantation, University Aldo Moro of Bari, 70124 Bari, Italy
Alfredo Di Leo: Section of Gastroenterology, Department of Emergency and Organ Transplantation, University Aldo Moro of Bari, 70124 Bari, Italy

IJERPH, 2020, vol. 17, issue 12, 1-12

Abstract: Inflammatory bowel diseases (IBD) have a large economic burden on health systems. Our single-centre observational retrospective study aimed to assess an economic evaluation in two IBD outpatient cohorts (biological and conventional therapy) in relation to disease activity within a three-year follow-up. Four hundred and seventeen consecutive IBD patients referred to our tertiary gastroenterology unit (Bari-Puglia-Southern Italy) on January 2014–December 2016 were included. For each group (conventional/biological), we assessed direct/indirect costs and clinical/endoscopic activity within the first year and along the three-year follow-up. Statistical analyses: Wilcoxon signed-rank test (continuous variables), chi-square and Fisher’s test (categorical variables), Spearman ranks (single outcome) and ANOVA (detection time, clinical/endoscopic scores) were used. Continuous variables were expressed as mean ± standard deviation and range and/or median, interquartile range and range; categorical variables were expressed as proportions with 95% confidence interval. Direct and indirect cost items of 2014 and 2014–2016 were higher in patients treated with biological than conventional therapy. Subjects on biological therapy were younger and showed clinical and endoscopic moderate-to-severe disease activity. After three years, they reached a significant improvement from baseline. Conversely, disease activity was mild when conventional treatment had a beneficial effect. In conclusion, overall IBD management cost matches with clinical course and needs long-term evaluation in critical patients.

Keywords: inflammatory bowel diseases; ulcerative colitis; Crohn’s disease; biological therapy; conventional therapy; direct costs; indirect costs (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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