Costs Of Inflammatory Bowel Disease-Related Hospitalizations And Surgeries: A Retrospective Analysis In A Commercially Insured Population

INTRODUCTION: Inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), is characterized by chronic inflammation of the gastrointestinal (GI) tract. Recent real-world evidence on costs of specific IBD-related events such as inpatient surgery for US patients treated with biologics is lacking. OBJECTIVE: To estimate disease-related hospitalizations and surgery utilization and costs for biologic-treated patients with IBD, stratified by CD and UC. METHODS: Adults with ≥2 medical claims for CD or UC diagnoses, respectively, from 1/1/2017 to 12/31/2017 were selected from the IBM MarketScan® Commercial Claims Database. Patients were required to have 12-month continuous enrollment and ≥1 medical or pharmacy claim for an FDA-approved biologic therapy for CD or UC in 2017. Patients were classified into the CD or UC cohort based on an adapted algorithm that uses the number of inpatient admissions and/or outpatient visits associated with each condition to assign patients to the CD or UC cohort. Mean disease-related hospitalizations and surgery utilization and costs were evaluated for IBD overall, and the CD and UC cohorts. Surgery-related inpatient costs per stay (ie, sum of costs incurred during IBD-surgery-related inpatient stays divided by number of stays) were also reported. Costs were reported in 2017 USD. RESULTS: A total of 19,879 patients with biologic-treated IBD (CD: n = 13,353; UC: n = 6,414) were included. The mean (±SD) age was 40 (±13) years; 49.5% were female (Table 1). About 17.4% of study patients had a disease-related hospitalization over the 12-month observation period, of which 27.7% had a corresponding surgery that incurred $43,803 (±$49,668) [mean (±SD)] surgery-related costs per stay (Table 2). In the CD cohort, 18.5% of patients had a disease-related hospitalization over 12 months, of which 31% had a surgery that incurred $43,454 (±$51,906) surgery-related costs per stay. In the UC cohort, 15.2% of the patients had a disease-related hospitalization, of which 19% had a surgery that incurred $45,540 (±$39,950) surgery-related costs per stay. CONCLUSION: IBD-related hospitalization and surgery rates appear consistent with those reported in prior studies, and costs associated with these events are substantial in a commercially insured population.Table 1Table 2