Kostić Marina, Djakovic Ljiljan, Šujić Raša, Godman Brian, Janković Slobodan M
Department of Pharmacology and Toxicology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.
Association of patients with Crohn's disease and Ulcerative colitis, Belgrade, Serbia.
Appl Health Econ Health Policy. 2017 Feb;15(1):85-93. doi: 10.1007/s40258-016-0272-z.
Although the costs of treating inflammatory bowel disease (IBD) in developed countries are well established, they remain largely unknown in countries with recent histories of socio-economic transition including Serbia.
To estimate the costs of treatment including the resources used by patients with IBD in Serbia from a societal perspective. This includes both Crohn's disease and ulcerative colitis.
This cost-of-illness study was conducted to identify direct, indirect and out-of-pocket costs of treating patients with IBD in Serbia. Patients with IBD (n = 112) completed a semi-structured questionnaire with data concerning their utilisation of heath-care resources and illness-related expenditures. All costs were calculated in Republic of Serbia dinars (RSD) at a 1-year level (2014) and subsequently converted to Euros. Median values and ranges were reported to avoid potential distortions associated with mean costs.
Median total direct costs and total indirect costs per patient per year in patients with Crohn's disease were 192,614.32RSD (€1602.97) and 28,014.00RSD (€233.13) and 142,267.15RSD (€1183.97) and 21,436.00RSD (€178.39), respectively, in patients with ulcerative colitis. In both groups, the greatest component of direct costs was hospitalisation.
Costs of IBD in Serbia are lower than in more developed countries for two reasons. These include the fact that expensive biological therapy is currently under-utilised in Serbia and prices of health services are largely controlled by the State at a low level. The under-utilisation of biologicals may change with the advent of biosimilars at increasingly lower prices.
虽然发达国家治疗炎症性肠病（IBD）的成本已为人熟知，但在包括塞尔维亚在内的近期经历社会经济转型的国家，这些成本仍基本未知。
从社会角度估算塞尔维亚IBD患者的治疗成本，包括所使用的资源。这包括克罗恩病和溃疡性结肠炎。
开展这项疾病成本研究，以确定塞尔维亚IBD患者的直接、间接和自付费用。IBD患者（n = 112）完成了一份半结构化问卷，内容涉及他们对医疗保健资源的使用情况和与疾病相关的支出。所有成本均以塞尔维亚第纳尔（RSD）按1年（2014年）计算，随后换算为欧元。报告中位数和范围，以避免与平均成本相关的潜在偏差。
克罗恩病患者每年每位患者的直接成本中位数和间接成本中位数分别为192,614.32塞尔维亚第纳尔（1602.97欧元）和28,014.00塞尔维亚第纳尔（233.13欧元），溃疡性结肠炎患者分别为142,267.15塞尔维亚第纳尔（1183.97欧元）和21,436.00塞尔维亚第纳尔（178.39欧元）。在两组中，直接成本的最大组成部分是住院费用。
塞尔维亚IBD的成本低于更发达国家，原因有两个。其中包括昂贵的生物疗法目前在塞尔维亚使用不足，以及医疗服务价格在很大程度上由国家控制在较低水平。随着价格越来越低的生物类似药的出现，生物制剂使用不足的情况可能会改变。
