OBJECTIVES : A literature review was conducted to identify reported trends in the worldwide incidence and prevalence of ulcerative colitis (UC), a common form of inflammatory bowel disease (IBD), and potential implications for the economic burden of UC.

METHODS : The MEDLINE database was searched to identify studies related to the epidemiology and costs of UC. Publications with English language abstracts from 2010 onwards were considered.

RESULTS : Published time-trend analyses have indicated global increasing incidence of UC between 1950-2010, followed by stabilisation/ reduction of incidence rates between 1990-2016 in Europe and North America. However, the incidence of UC continues to increase in newly industrialised countries, which is considered to be linked to the westernisation of diets and environments. Despite stabilisation of incidence in western countries, prevalence continues to increase. A 2017 review reported that prevalence has exceeded 0.3% of the total population in North America, Australia, and many European countries. A forecast of the global burden of IBD between 2015 and 2025 predicted exponential growth of the number of patients, due to increased rates of diagnosis and low mortality. UC is associated with high cost burden, a 2010 review estimated the total economic burden of UC to be €12.5-€29.1 billion in Europe and $8.1-$14.9 billion in the US. According to this review, hospitalisations are the largest contributor to direct medical costs. However, a recent study indicates that the proportion of anti-TNF (biologics) related costs are increasing. Although the introduction of biosimilars may reduce costs, this may be offset by the increasing number of patients requiring treatment.

CONCLUSIONS : Healthcare systems worldwide should be aware of the increasing prevalence of UC, which may result in increased economic burden. As reported incidence and prevalence rates have recently increased, updated epidemiology studies are required to ensure data used in economic models is up-to-date and region-specific.