Long-term evolution of direct healthcare costs for inflammatory bowel diseases: a population-based study (2006–2015)

Jung Wook Kim, Chang Kyun Lee, Jung Kuk Lee, Su Jin Jeong, Shin Ju Oh, Jung Rock Moon, Hyun Soo Kim, Hyo Jong Kim

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Introduction: We explored the long-term evolution of direct healthcare costs for inflammatory bowel diseases (IBD) using a population-level database in a country with an escalating burden of IBD. Methods: We searched the database of the Korean National Health Insurance Claims, which covers more than 97% of the South Korean population. An IBD diagnosis was defined as the combination of a billing code for Crohn’s disease (CD: K50.xx) or ulcerative colitis (UC: K51.xx) and at least one claim for IBD-specific drugs. Between 2006 and 2015, a total of 59,447 patients (CD: 17,677; UC: 41,770) were included. Results: The total and mean cost per capita increased significantly over time. In the last year of the study (2015), the cost for anti-tumor necrosis factor (TNF) therapy accounted for 68.8% (CD) and 48.8% (UC) of the total cost. Age at diagnosis (<20 years vs. ≥30 years) and anti-TNF use were independent predictors of increased total IBD cost. Anti-TNF therapy was the strongest predictor of high-cost outliers (designated as the top 20 percentile of the total costs) for IBD (OR: 160.4; 95% CI: 89.0–289.2). The mean cost among patients with newly diagnosed CD increased significantly over the 8-year follow-up period (p =.03), while costs associated with UC remained stable. Only medication costs increased significantly during the follow-up period for CD. Conclusions: Over the past 10 years, the increased usage of anti-TNF agents has been the key driver of IBD-related healthcare costs. Long-term cost-cutting strategies for patients with CD are warranted.

Original languageEnglish
Pages (from-to)419-426
Number of pages8
JournalScandinavian Journal of Gastroenterology
Volume54
Issue number4
DOIs
Publication statusPublished - 2019 Apr 3

Fingerprint

Inflammatory Bowel Diseases
Health Care Costs
Costs and Cost Analysis
Population
Tumor Necrosis Factor-alpha
Databases
Cost of Illness
National Health Programs
Ulcerative Colitis
Crohn Disease
Therapeutics
Pharmaceutical Preparations

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

Kim, Jung Wook ; Lee, Chang Kyun ; Lee, Jung Kuk ; Jeong, Su Jin ; Oh, Shin Ju ; Moon, Jung Rock ; Kim, Hyun Soo ; Kim, Hyo Jong. / Long-term evolution of direct healthcare costs for inflammatory bowel diseases : a population-based study (2006–2015). In: Scandinavian Journal of Gastroenterology. 2019 ; Vol. 54, No. 4. pp. 419-426.
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abstract = "Introduction: We explored the long-term evolution of direct healthcare costs for inflammatory bowel diseases (IBD) using a population-level database in a country with an escalating burden of IBD. Methods: We searched the database of the Korean National Health Insurance Claims, which covers more than 97{\%} of the South Korean population. An IBD diagnosis was defined as the combination of a billing code for Crohn’s disease (CD: K50.xx) or ulcerative colitis (UC: K51.xx) and at least one claim for IBD-specific drugs. Between 2006 and 2015, a total of 59,447 patients (CD: 17,677; UC: 41,770) were included. Results: The total and mean cost per capita increased significantly over time. In the last year of the study (2015), the cost for anti-tumor necrosis factor (TNF) therapy accounted for 68.8{\%} (CD) and 48.8{\%} (UC) of the total cost. Age at diagnosis (<20 years vs. ≥30 years) and anti-TNF use were independent predictors of increased total IBD cost. Anti-TNF therapy was the strongest predictor of high-cost outliers (designated as the top 20 percentile of the total costs) for IBD (OR: 160.4; 95{\%} CI: 89.0–289.2). The mean cost among patients with newly diagnosed CD increased significantly over the 8-year follow-up period (p =.03), while costs associated with UC remained stable. Only medication costs increased significantly during the follow-up period for CD. Conclusions: Over the past 10 years, the increased usage of anti-TNF agents has been the key driver of IBD-related healthcare costs. Long-term cost-cutting strategies for patients with CD are warranted.",
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Long-term evolution of direct healthcare costs for inflammatory bowel diseases : a population-based study (2006–2015). / Kim, Jung Wook; Lee, Chang Kyun; Lee, Jung Kuk; Jeong, Su Jin; Oh, Shin Ju; Moon, Jung Rock; Kim, Hyun Soo; Kim, Hyo Jong.

In: Scandinavian Journal of Gastroenterology, Vol. 54, No. 4, 03.04.2019, p. 419-426.

Research output: Contribution to journalArticle

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T1 - Long-term evolution of direct healthcare costs for inflammatory bowel diseases

T2 - a population-based study (2006–2015)

AU - Kim, Jung Wook

AU - Lee, Chang Kyun

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AU - Jeong, Su Jin

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AU - Moon, Jung Rock

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AU - Kim, Hyo Jong

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N2 - Introduction: We explored the long-term evolution of direct healthcare costs for inflammatory bowel diseases (IBD) using a population-level database in a country with an escalating burden of IBD. Methods: We searched the database of the Korean National Health Insurance Claims, which covers more than 97% of the South Korean population. An IBD diagnosis was defined as the combination of a billing code for Crohn’s disease (CD: K50.xx) or ulcerative colitis (UC: K51.xx) and at least one claim for IBD-specific drugs. Between 2006 and 2015, a total of 59,447 patients (CD: 17,677; UC: 41,770) were included. Results: The total and mean cost per capita increased significantly over time. In the last year of the study (2015), the cost for anti-tumor necrosis factor (TNF) therapy accounted for 68.8% (CD) and 48.8% (UC) of the total cost. Age at diagnosis (<20 years vs. ≥30 years) and anti-TNF use were independent predictors of increased total IBD cost. Anti-TNF therapy was the strongest predictor of high-cost outliers (designated as the top 20 percentile of the total costs) for IBD (OR: 160.4; 95% CI: 89.0–289.2). The mean cost among patients with newly diagnosed CD increased significantly over the 8-year follow-up period (p =.03), while costs associated with UC remained stable. Only medication costs increased significantly during the follow-up period for CD. Conclusions: Over the past 10 years, the increased usage of anti-TNF agents has been the key driver of IBD-related healthcare costs. Long-term cost-cutting strategies for patients with CD are warranted.

AB - Introduction: We explored the long-term evolution of direct healthcare costs for inflammatory bowel diseases (IBD) using a population-level database in a country with an escalating burden of IBD. Methods: We searched the database of the Korean National Health Insurance Claims, which covers more than 97% of the South Korean population. An IBD diagnosis was defined as the combination of a billing code for Crohn’s disease (CD: K50.xx) or ulcerative colitis (UC: K51.xx) and at least one claim for IBD-specific drugs. Between 2006 and 2015, a total of 59,447 patients (CD: 17,677; UC: 41,770) were included. Results: The total and mean cost per capita increased significantly over time. In the last year of the study (2015), the cost for anti-tumor necrosis factor (TNF) therapy accounted for 68.8% (CD) and 48.8% (UC) of the total cost. Age at diagnosis (<20 years vs. ≥30 years) and anti-TNF use were independent predictors of increased total IBD cost. Anti-TNF therapy was the strongest predictor of high-cost outliers (designated as the top 20 percentile of the total costs) for IBD (OR: 160.4; 95% CI: 89.0–289.2). The mean cost among patients with newly diagnosed CD increased significantly over the 8-year follow-up period (p =.03), while costs associated with UC remained stable. Only medication costs increased significantly during the follow-up period for CD. Conclusions: Over the past 10 years, the increased usage of anti-TNF agents has been the key driver of IBD-related healthcare costs. Long-term cost-cutting strategies for patients with CD are warranted.

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