Boston, MA, USA.
Stockholm, Sweden.
Aliment Pharmacol Ther. 2020 Aug;52(4):655-668. doi: 10.1111/apt.15889. Epub 2020 Jul 3.
There are limited data on population-wide assessment of cost in Crohn's disease (CD) and ulcerative colitis (UC).
To estimate the societal cost of actively treated CD and UC in Sweden.
We identified 10 117 prevalent CD and 19 762 prevalent UC patients, aged ≥18 years on 1 January 2014 and 4028 adult incident CD cases and 8659 adult incident UC cases (2010-2013) from Swedish Patient Register. Each case was matched to five population comparators. Healthcare costs were calculated from medications, outpatient visits, hospitalisations and surgery. Cost of productivity losses was derived from disability pension and sick leave.
The mean annual societal costs per working-age patient (18-64 years) with CD and UC were $22 813 (vs $7533 per comparator) and $14 136 (vs $7351 per comparator), respectively. In patients aged ≥65 years, the mean annual costs of CD and UC were $9726 and $8072 vs $3875 and $4016 per comparator, respectively. The majority of cost for both CD (56%) and UC (59%) patients originated from productivity losses. Higher societal cost of working-age CD patients as compared to UC patients was related to greater utilisation of anti-TNF (22.2% vs 7.4%) and increased annual disability pension (44 days vs 25 days). Among incident CD and UC patients, the mean total cost over the first year per patient was over three times higher than comparators.
In Sweden, the societal cost of incident and prevalent CD and UC patients was consistently two to three times higher than the general population.
目前针对克罗恩病(CD)和溃疡性结肠炎(UC)的人群成本评估数据有限。
评估瑞典活跃治疗的 CD 和 UC 的社会成本。
我们从瑞典患者登记处确定了 10117 例现患 CD 和 19762 例现患 UC 患者,年龄均≥18 岁,发病日期为 2014 年 1 月 1 日;4028 例成人新发病 CD 病例和 8659 例成人新发病 UC 病例(2010-2013 年)。每个病例都与五个人群对照相匹配。医疗保健成本是根据药物、门诊就诊、住院和手术计算的。生产力损失的成本是从残疾抚恤金和病假中得出的。
患有 CD 和 UC 的工作年龄患者(18-64 岁)的年均社会成本分别为 22813 美元(对照为 7533 美元)和 14136 美元(对照为 7351 美元)。年龄≥65 岁的 CD 和 UC 患者的年均成本分别为 9726 美元和 8072 美元,对照分别为 3875 美元和 4016 美元。CD(56%)和 UC(59%)患者的大部分成本都来自生产力损失。与 UC 患者相比,工作年龄 CD 患者的社会成本更高,这与抗 TNF 的使用量更大(22.2%对 7.4%)和每年残疾抚恤金天数增加(44 天对 25 天)有关。在新发 CD 和 UC 患者中,每位患者第一年的平均总费用是对照的三倍多。
在瑞典,新发和现患 CD 和 UC 患者的社会成本始终比普通人群高 2 到 3 倍。