Comparison Of Absenteeism And Total Health Care Expenditures For Inflammatory Bowel Disease Pre And Post Anti-Tnf Use

s A207 were collected for the health care services. Out-of-pocket (OOP) costs were the portion of individuals’ total payments for the health care services. To estimate the health care and OOP costs, a multivariable linear regression analysis was performed. Costs were adjusted for patient demographics and comorbidities. All costs were inflated using the medical component of the 2008 Consumer Price Index (CPI). RESULTS: There were 873 individuals with PsO (mean age = 51 years; 52% female), and 160,617 individuals without PsO, (mean age = 48 years; 58% female). Annual per capita health care costs for individuals with PsO were higher than those for individuals without PsO ($4543 vs. $3828; P = 0.0007). Annual per capita OOP costs for individuals with PsO were also higher than those of individuals without PsO ($1250 vs. $917; P < 0.0001). The total annual per capita direct medical costs was $5793 when combining health care and OOP costs for PsO. The US national annual estimates of health care, OOP, and total direct medical costs for PsO were $0.77 billion, $0.36 billion, and $1.1 billion, respectively. CONCLUSIONS: The direct medical costs associated with PsO are substantial not only to health care payers but to patients as well. The extent to which appropriate and early diagnosis and treatment of PsO reduce total health care costs for individuals with these diseases should be examined. PSY11 THE INDIRECT COSTS OF INFLAMMATORY BOWEL DISEASE: EVIDENCE FROM UNITED STATES NATIONAL SURVEY DATA Lofland J, Naim A, Rizzo J, Gunnarsson C, Chen J, Waters H Centocor Ortho Biotech Services, LLC, Horsham, PA, USA, Stony Brook University, Stony Brook, NY, USA, S2 Statistical Solutions Inc, Cincinnati, OH, USA, College of Staten Island/ CUNY, Staten Island, NY, USA OBJECTIVES: To quantify individual and national estimates of the indirect costs of inflammatory bowel disease (IBD), Crohn’s disease (CD), and ulcerative colitis (UC), using national survey data. METHODS: This was a retrospective study using 1996– 2006 data from the Medical Expenditure Panel Survey (MEPS). Individuals selfreported health conditions were mapped to the International Classification of Diseases, 9 Revision, Clinical Modification (ICD-9-CM) diagnostic codes. Individuals with an ICD-9-CM diagnostic code of 555.x (CD) or 556.x (UC) were categorized as having IBD. A two-part model was specified to estimate the probability of time lost from work and the annual number of workdays missed due to illness, conditional on missing at least 1 workday. The annual missed workdays were combined with MEPS earnings information to estimate individual and national indirect costs. RESULTS: There were 200 patients with IBD (mean age = 43.0 years; 54% Female), and 89,846 individuals without IBD (mean age = 40.8; 52% Female), included in the analysis. The study revealed 71.9% (144/200) of individuals with IBD missed work as compared with 58.3% (52,110/89,846) of those without IBD (p = 0.0001). Among those individuals who missed work, individuals with IBD had a mean annual number of missed workdays of 13.95 versus 9.83 missed workdays for individuals without IBD (p = 0.004). The per capita indirect costs associated with the incremental difference in annual lost workdays between those with and without IBD was $485. The estimated national indirect costs associated with IBD were $205 million per year. CONCLUSIONS: Compared to individuals without IBD, individuals with IBD have a higher probability of missing work and missing more workdays. The per capita and national annual indirect costs associated with IBD are substantial. The ability of appropriate and early diagnosis and treatment of IBD to reduce time lost from work and indirect costs for individuals with IBD should be examined. PSY12 COMPARISON OF ABSENTEEISM AND TOTAL HEALTH CARE EXPENDITURES FOR SELECT AUTO-IMMUNE INFLAMMATORY DISORDERS (AIID) PRE AND POST ANTI-TNF USE—AN EMPLOYER’S PERSPECTIVE Naim A, Nair KV, Bolge S, Draaghtel K, Van Den Bos J Centocor Ortho Biotech Services, LLC, Horsham, PA, USA, University of Colorado, Aurora, CO, USA, Milliman, Inc, Denver, CO, USA OBJECTIVES: To compare direct and absenteeism-related indirect expenditures among employees suffering from an AIID pre and post anti-TNF use. METHODS: A retrospective analysis was performed using the Thomson Reuters MarketScan® and the Health and Productivity Management databases (2000–2007). Study group consisted of members with primary diagnosis for at least one of six AIIDs (Rheumatoid Arthritis, Psoriasis, Psoriatic Arthritis, Crohn’s Disease, Ulcerative Colitis, Ankylosing Spondylosis) and at least one prescription for an anti-TNF (adalimumab, etanercept, or infliximab) in the same calendar year. Direct expenditures included medical expenditures (inpatient, outpatient, emergency department, and other medical services) and pharmacy expenditures. Indirect expenditures included expenditures related to absenteeism. Regression analysis was used to compare the mean number of annual absentee days, indirect expenditures associated with absences, direct expenditures (medical and pharmacy), and total expenditures during the 12 months prior versus the 12 months following initiation of anti-TNF treatment. RESULTS: The study group (n = 689) was 39% female with 94% in a managed care plan and had a mean age of 44.3 years. Only 22% had more than one AIID condition. Following the use of anti-TNFs, absenteeism decreased by 15.4% with lower indirect expenditures ($1172 vs. $1000), lower medical expenditures ($7517 vs. $6434), and lower non anti-TNF pharmacy expenditures ($1934 vs. $1604). Direct expenditures were higher ($22,658 vs. $9450) due to the cost of anti-TNF treatment ($14,620). Consequently, total expenditures (direct and indirect) were also higher following anti-TNF use ($23,657 vs. $10,623). CONCLUSIONS: AIIDs are debilitating disorders that result in reduced productivity and time lost from work. Members with at least one AIID who received anti-TNF treatments, had lower absenteeism and indirect health care costs and higher direct costs. Appropriate management of these conditions with anti-TNF agents may provide greater indirect costs savings which could offset the direct costs. PSY13 COMPARISON OF TOTAL HEALTH CARE EXPENDITURES AND ABSENTEEISM FOR INFLAMMATORY BOWEL DISEASE FROM AN EMPLOYER’S PERSPECTIVE Naim A, Nair KV, Van Den Bos J, Draaghtel K, Waters H Centocor Ortho Biotech Services, LLC, Horsham, PA, USA, University of Colorado, Aurora, CO, USA, Milliman, Inc, Denver, CO, USA OBJECTIVES: To compare direct and absenteeism-related indirect expenditures among employees with inflammatory bowel disease (IBD) (Crohn’s Disease, Ulcerative Colitis) with employees who do not have IBD. METHODS: A retrospective analysis was performed using the Thomson Reuters MarketScan® and the Health and Productivity Management databases between 2000–2006. Propensity analysis adjusting for various demographic and clinical variables was used to create 1) control: no diagnosis of any IBD; and 2) IBD group: primary diagnosis of at least one IBD. Direct expenditures included medical expenditures (inpatient, outpatient, emergency department, and other medical services) and pharmacy expenditures. Indirect expenditures included expenditures related to absenteeism. Regression analysis was used to compare the mean number of annual absentee days, indirect expenditures associated with absences, direct expenditures (medical and pharmacy), and total expenditures between the two groups. RESULTS: The 2201 employees in the IBD group were matched to 8,788 employees in the control group (mean age 42.2 years; mean risk score was 3.43; 40% female; with 94% in managed care). Compared to the control group, the IBD group had slightly higher rate of absenteeism (9.1 vs. 9.0 days, slightly higher indirect expenditures ($1170 vs. $1129), higher direct expenditures ($8870 vs. $7500) including medical expenditures ($6860 vs. $6096), and non anti-TNF pharmacy expenditures ($1609 vs. $1404). The total expenditures (direct and indirect) were also higher for the IBD group ($9950 vs. $8630) compared to the control group. CONCLUSIONS: IBD is a debilitating disease that results in reduced productivity and time lost from work. Employees with IBD have a higher total health care expenditure burden. Appropriate management of IBD can reduce costs for employers and payers. Further analyses are needed to determine the impact of various treatment(s) on lost productivity and direct and indirect expenditures. PSY14 COMPARISON OF ABSENTEEISM AND TOTAL HEALTH CARE EXPENDITURES FOR INFLAMMATORY BOWEL DISEASE PRE AND POST ANTI-TNF USE Naim A, Nair KV, Van Den Bos J, Draaghtel K, Waters H Centocor Ortho Biotech, Horsham, PA, USA, University of Colorado, Aurora, CO, USA, Milliman, Inc, Denver, CO, USA, Centocor Ortho Biotech Services, LLC, Horsham, PA,