OBJECTIVES: The societal burden of inflammatory bowel diseases (IBD) is not well documented in the literature, and further studies are needed to quantify these costs per disease state. This study aimed to estimate the societal burden and identify predictors of work productivity and activity impairment, productivity costs, and out-of-pocket costs related to IBD.

METHODS: A cross-sectional questionnaire-based study was performed among adult Czech patients with Crohn’s disease (CD) and ulcerative colitis (UC). Data were collected from 4/2021 to 3/2022 using electronic patient questionnaires. Productivity costs were assessed using a human capital approach. Associations were assessed using multivariate linear regression.

RESULTS: We analyzed data from 162 questionnaires (CD: n=105, UC: n=57). The overall work impairment reached 15.4%; 11.2% vs. 28.8% without/with self-reported symptoms (p=0.006). Daily activity impairment was 19.3%; 14.1% vs. 35.6% (p<0.001). The disability pension rate was 27.8%; 22.8% vs. 43.6% (p=0.011).

The total loss of productivity due to absenteeism, presenteeism and disability summed up to 7,649 €/patient/year overall, 6,002 and 12,354 €/patient/year without/with self-reported symptoms, respectively (p=0.001). Out-of-pocket costs amounted to 559 €/patient/year overall, 469 vs. 844 €/patient/year without/with self-reported symptoms, respectively (p<0.001). Differences in productivity and out-of-pocket costs between patients without/with self-reported symptoms remained significant even after adjustment to other characteristics. According to the multivariate linear regression analysis, self-reported symptoms (i.e., disease activity) were the only independent predictor of patient productivity and costs (p<0.001). Age, disease duration, gender, IBD type, smoking, and BMI had no measurable impact.

CONCLUSIONS: This study revealed a high societal burden of IBD and a significant association of work disability, daily activity impairment, disability pension, and out-of-pocket costs with patient-reported disease symptoms. The results indicate that induction and maintenance of remission in all participants with active disease can lower indirect costs by more than half.