Direct Healthcare Costs of Inflammatory Bowel Diseases in Lombardy

Background Ulcerative colitis (UC) and Crohn’s disease (CD), collectively known as inflammatory bowel diseases (IBD), are chronic gastrointestinal conditions of unknown origin. Several reports suggest that these diseases are costly and represent a considerable burden to national healthcare systems (HSs), both in Europe and North America. Detailed cost studies of IBD in Italy are limited. The aim of this study was to estimate healthcare resource use and direct costs related to IBD from the perspective of HS in Lombardy, a region in Northern Italy. Methods This is an observational study based on healthcare administrative databases of Lombardy region. Data were previously organized in a data warehouse (DENALI) with probabilistic record linkage. We enrolled two study cohorts, one of patients with recently diagnosed UC and the other with CD. Subjects were identified on the basis of issuing of an exemption from co-payment healthcare costs between January 1st, 2003 and December 31st, 2009, for CD (code 009.555) or UC (code 009.556). The date of beginning of exemption was the entry date of the study. Subjects covered by Lombardy HS since less than 1 year were excluded. The two cohorts were followed until December 31st, 2009 to assess the consumption of healthcare resources (hospitalizations, pharmaceutical prescriptions and outpatient services) and the related costs incurred by the HS. Results Overall 5,637 subjects with UC and 3,398 with CD were included in the study. The mean age at CD diagnosis was 43 years (±17.2 s.d.), which was lower than that at UC diagnosis (45 ± 17.2, p<0.0001). During a mean follow-up time of 3.4 years (± 2.0), 2.2% of patients died in each cohort.