COSTS AND COST DRIVERS OF INFLAMMATORY BOWEL DISEASE IN THE UNITED KINGDOM: EVIDENCE FROM A LARGE PATIENT SURVEY USING TWEEDIE REGRESSION
Author(s)
Zarina Zhunissova, MRes1, Chris Roukas, PhD1, James O. Lindsay, MD2, Christine Norton, PhD3, Borislava Mihaylova, PhD1.
1Health Economics and Policy Research Unit, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom, 2Centre for Immunobiology, Blizard Institute, Faculty of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom, 3Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom.
1Health Economics and Policy Research Unit, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom, 2Centre for Immunobiology, Blizard Institute, Faculty of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom, 3Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom.
OBJECTIVES: Inflammatory bowel disease (IBD), including Crohn’s disease (CD), ulcerative colitis (UC), and IBD unclassified (IBDU), causes chronic intestinal inflammation and is associated with substantial healthcare and other resource use. This study estimated the contemporary IBD-related costs and identified key cost drivers.
METHODS: Data were obtained from the IBD Resource Use Questionnaire completed by 1,839 adults with IBD recruited through the UK IBD BioResource and Barts Health NHS IBD clinics. Healthcare use, private costs, and productivity losses reported over three months were valued using national unit costs (2024 GBP). As total costs were right-skewed and 9% of participants reported zero costs, a generalised linear model with a Tweedie distribution and log link was used. Sequential models were fitted, adjusting first for sociodemographic factors, then additionally for clinical characteristics and disease activity, and finally for disease control.
RESULTS: Mean (SD) three-month total costs were higher in CD than in UC/IBDU (£3391 [£8297] versus £2113 [£5132]; p<0.05). Healthcare costs accounted for the largest share in both groups (CD: £2524 [£7803]; UC/IBDU: £1540 [£4267]), followed by private costs (CD: £592 [£1508]; UC/IBDU: £294 [£1066]). Among working adults, productivity losses were £393 (£1217) in CD and £220 (£936) in UC/IBDU. Medication costs represented the largest healthcare subcomponent, accounting for 41% of healthcare costs in CD and 53% in UC/IBDU. In the fully adjusted model, active disease and poor disease control were associated with 30% and 90% higher total costs, respectively (cost ratios 1.3 (95% CIs 1.1-1.6) and 1.9 (1.6-2.3)).
CONCLUSIONS: Across both CD and UC/IBDU, healthcare costs were the largest cost component, followed by private and productivity costs. Costs were markedly higher among patients with active or poorly controlled disease, highlighting the economic burden associated with suboptimal disease status. These findings support focus on disease activity and control in IBD service planning, resource allocation, and intervention development.
METHODS: Data were obtained from the IBD Resource Use Questionnaire completed by 1,839 adults with IBD recruited through the UK IBD BioResource and Barts Health NHS IBD clinics. Healthcare use, private costs, and productivity losses reported over three months were valued using national unit costs (2024 GBP). As total costs were right-skewed and 9% of participants reported zero costs, a generalised linear model with a Tweedie distribution and log link was used. Sequential models were fitted, adjusting first for sociodemographic factors, then additionally for clinical characteristics and disease activity, and finally for disease control.
RESULTS: Mean (SD) three-month total costs were higher in CD than in UC/IBDU (£3391 [£8297] versus £2113 [£5132]; p<0.05). Healthcare costs accounted for the largest share in both groups (CD: £2524 [£7803]; UC/IBDU: £1540 [£4267]), followed by private costs (CD: £592 [£1508]; UC/IBDU: £294 [£1066]). Among working adults, productivity losses were £393 (£1217) in CD and £220 (£936) in UC/IBDU. Medication costs represented the largest healthcare subcomponent, accounting for 41% of healthcare costs in CD and 53% in UC/IBDU. In the fully adjusted model, active disease and poor disease control were associated with 30% and 90% higher total costs, respectively (cost ratios 1.3 (95% CIs 1.1-1.6) and 1.9 (1.6-2.3)).
CONCLUSIONS: Across both CD and UC/IBDU, healthcare costs were the largest cost component, followed by private and productivity costs. Costs were markedly higher among patients with active or poorly controlled disease, highlighting the economic burden associated with suboptimal disease status. These findings support focus on disease activity and control in IBD service planning, resource allocation, and intervention development.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HTA248
Topic
Economic Evaluation, Health Technology Assessment, Methodological & Statistical Research
Topic Subcategory
Value Frameworks & Dossier Format
Disease
Gastrointestinal Disorders, No Additional Disease & Conditions/Specialized Treatment Areas