Burden of Crohn’s disease in the United States: long-term healthcare and work-loss related costs

Abstract

Aims: To quantify the long-term direct and indirect costs among patients with Crohn’s disease (CD) and specific subgroups of these patients in the United States from the private payer’s perspective. Materials and methods: This retrospective study used the OptumHealth Care Solutions, Inc database (01 January 1999–31 March 2017) to match (1:5) adult patients with ≥2 claims for CD to patients without inflammatory bowel disease (IBD). Patterns observed during follow-up (i.e. biologics, opioids, or steroids; CD-related surgery; moderate-to-severe disease; and comorbidities) were used to identify CD subgroups. Comparisons of healthcare resource utilization, work loss days, and direct and indirect work loss-related costs were made between matched cohorts. Descriptive analyses of costs were conducted within each CD subgroup. Results: There were 6,715 and 33,575 patients in the CD and non-IBD cohorts, respectively. The direct burden was significantly higher in the CD cohort compared to the non-IBD cohort, with 0.34 inpatient admissions per patient per year (PPPY) versus 0.12 (217% increase; p