OBJECTIVES: To evaluate the association of patient cost or reimbursement challenges with healthcare resource utilization, quality of life (QoL), and work productivity among patients with inflammatory bowel disease (IBD). METHODS: A syndicated study of IBD patients in the US was conducted.  Patients ≥18 years of age were recruited via the National Health and Wellness Survey and Lightspeed Research Panel.  Patients completed a survey during August–November 2010 in which they were asked if they experienced cost or reimbursement challenges related to prescription medication.  The Medical Outcomes Study (MOS) IBD questionnaire was used to assess QoL.  Work productivity was assessed using the Work Productivity and Activity Impairment (WPAI) questionnaire.  To measure health care resource utilization, the number of provider, emergency room (ER) and hospital visits in the past six months was collected.  Bivariate differences between the patient groups (those with cost or reimbursement issues versus those without) for resource utilization, QoL, and work impairment were assessed using chi-square tests for categorical variables and t-tests for continuous variables. RESULTS: Of 1098 IBD patients currently receiving prescription medication, 21% (n=231) reported that cost had previously prevented them from taking medication.   Among patients who had ever taken prescription medication (n=1343), 13% (n=178) reported ever having a problem getting reimbursed for medication. Sixty-eight of these patients (38%) indicated their medication was not covered by insurance.  Patients reporting cost or reimbursement issues had a higher probability of having provider, ER and hospital visits in the prior six months (all p<0.05).  Furthermore, these patients reported greater work impairment and lower QoL (both p<0.05).      CONCLUSIONS: Among IBD patients, cost or reimbursement challenges may be associated with more resource utilization, lower QoL and greater work impairment.  Additional research is warranted to further characterize the impact of cost and reimbursement on patient outcomes.