OBJECTIVES: Inflammatory bowel disease (IBD) constitute a significant burden for both patients and the society. The aim of our study was to assess the total direct costs of IBD in Poland.

METHODS: Information on drugs, dietary supplements, medical devices, outpatient and inpatient services utilized by 60,472 IBD patients from Poland for the years 2012-2014 were collected from databases of the National Health Fund (NHF), the payer for medical services in Poland. Nonparametric Pearson chi2 test and Kruskal-Wallis H test with Bonferroni correction for multiple hypothesis testing were used to compare expenditures or treatment utilization by year, patient’s age and IBD diagnosis.

RESULTS: Expenditures from public payer’s budget among IBD patients were from PLN289.57 million (€69 million) in 2012, PLN305.55 million (€72.75 million) in 2013 and PLN276.54 million (€65.84 million) in 2014. The cost of inpatient and outpatient services accumulated of around half of total expenditures. The main component of public payer’s expenditures was associated with surgical and medical procedures, including biologic treatment. The utilization of pharmacotherapies differed by age and diagnosis (adjusted for multiplicity p value < 0.001). Biologics, steroids and immunomodulatory drugs were significantly more often used by patients with Crohn disease (CD) then patients with ulcerative colitis (UC). However, consumption of aminosalicylates was more common among UC patients. The use of biologics was the highest among young patients with IBD and the lowest among the oldest patients (0.1% in patients 65+ years).

CONCLUSIONS: Direct cost of IBD in Poland impose a significant burden for NHF with around €70 million annually. Moreover, the study revealed that the treatment pattern and drug utilization depends on patient’s age and diagnosis (“stronger” drugs were more often incorporated into treatment of younger patients and patients with CD).