OBJECTIVES: Long-term corticosteroid (CS) exposure is associated with potential adverse effects, with a negative impact on quality of life and healthcare costs. The objective of this analysis was to assess the pharmacoeconomic consequences of adverse events due to systemic CS in patients with ulcerative colitis and to evaluate the potential economic impact.

METHODS: A budget impact model was developed, carried out from the perspective of the Italian NHS with a 10-year time horizon. Three distinct treatment groups were defined: CS use for <3 months (27%), between 3–6 months (15%) and >6 months (59%). Results were examined at 3, 5 and 10 years. A sensitivity analysis and simulation scenario assessing the economic impact of 20%, 35% and 50% reductions in CS use were also carried out.

RESULTS: The average annual cost per patient due to CS adverse event management was €3,845. The cumulative impact of CS treatment was estimated to be €765.6 million, €1.3 billion and €3.1 billion, respectively after 3, 5 and 10 years. A 20% reduction in CS use can generate savings of about €153.1 million, €270.9 million and €619.8 million, respectively after 3, 5 and 10 years.

Reductions in CS use of 35% resulted in savings of €267.9 million, €473.9 million and €1.1 billion at 3, 5 and 10 years, respectively. With a reduction of 50%, savings were equal to €382.8 million, €677.1 million and €1.5 billion.

CONCLUSIONS: Our results highlight the significant impact on healthcare costs of AEs related to systemic CS treatment, and the potential benefits obtainable from reducing this therapy over time. This should be further tested in real-world studies. Lastly, these results may suggest the importance of opting for treatment with more innovative therapies, characterized by higher purchase costs, but with a steroid-sparing effect.