OBJECTIVES: This study aimed to analyze the medication use and healthcare resource utilization (HCRU) of Ulcerative Colitis (UC) patients in the United States (US) adult insured population from 2007 to 2017.

METHODS: Trends in medication use and HCRU (emergency room (ER) visits, inpatient visits, outpatient visits, and surgery) were calculated for the 11-year period covering January 1, 2007 to December 31, 2017. Adult (18+ years) patients with ≥1 UC diagnostic code (ICD-9: 556.x; ICD-10:K51.x) within the calendar year were included in this retrospective analysis of medical and pharmacy claims data from the IBM Marketscan Commercial, Medicaid, and Medicare-Supplemental Claims database. Patients with a Crohn’s Disease diagnosis were excluded from this study. Subgroup analyses were conducted to compare UC patients prescribed biologics and those not prescribed biologics during each calendar year.

RESULTS: The prevalence of biologic use among UC patients increased from 1.9% in 2007 to 12.5% in 2017. Overall rates of corticosteroids increased (28.6% to 31.1%); however, corticosteroid use among biologic users decreased from 60.5% in 2007 to 47.2% in 2017. Opioid use also decreased from 53.6% to 40.3% among biologic users. Rates of surgery decreased in the entire UC population from 2.1% of patients (biologic: 3.9%, non-biologic: 2.1%) in 2007 to 1.6% (biologic: 1.9%, non- biologic: 1.5%) in 2017. UC specific ER visits increased for both biologic and non-biologic users from 4.4% to 6.7%, however inpatient hospital stays decreased from 9.5% to 8.3%.

CONCLUSIONS: This study provides real-world evidence on the medication use and HCRU of insured adults with UC in the US. From 2007-2017, there was an overall increase in the use of biologics and corticosteroids, however among biologic users rates of corticosteroids and opioids decreased. Ongoing real-word data are needed to capture changes in HCRU patterns and cost due to the evolving UC treatment landscape.