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Observational Study
. 2019 May 7;19(1):69.
doi: 10.1186/s12876-019-0985-1.

Economic burden of moderate to severe irritable bowel syndrome with constipation in six European countries

Jan Tack  1   2 , Vincenzo Stanghellini  3 , Fermín Mearin  4 , Yan Yiannakou  5 , Peter Layer  6 , Benoit Coffin  7 , Magnus Simren  8 , Jonathan Mackinnon  9 , Gwen Wiseman  10 , Anne Marciniak  10 ; IBIS-C Study group
Collaborators, Affiliations
Observational Study

Economic burden of moderate to severe irritable bowel syndrome with constipation in six European countries

Jan Tack et al. BMC Gastroenterol. .

Abstract

Background: Irritable bowel syndrome with predominant constipation (IBS-C) is a complex disorder with gastrointestinal and nervous system components. The study aim was to assess the economic burden of moderate to severe IBS-C in six European countries (France, Germany, Italy, Spain, Sweden and the UK).

Methods: An observational, one year retrospective-prospective (6 months each) study of patients diagnosed in the last five years with IBS-C (Rome III criteria) and moderate to severe disease at inclusion (IBS Symptom Severity Scale score ≥ 175). The primary objective was to assess the direct cost to European healthcare systems.

Results: Five hundred twenty-five patients were included, 60% (range: 43.1-78.8%) suffered from severe IBS-C. During follow-up 11.1-24.0% of patients had a hospitalisation/emergency room (ER) visit, median stay range: 1.5-12.0 days and 41.1-90.4% took prescription drugs for IBS-C. 21.4-50.8% of employed patients took sick leave (mean: 11.6-64.1 days). The mean annual direct cost to the healthcare systems was €937.1- €2108.0. The total direct cost (combined costs to healthcare systems and patient) for IBS-C was €1421.7-€2487.1.

Conclusions: IBS-C is not a life-threatening condition; however, it has large impact on healthcare systems and society. Direct and indirect costs for moderate to severe IBS-C were high with the largest direct cost driver being hospitalisations/ER visits.

Keywords: Economic analysis; Europe; Healthcare resource utilisation; IBS; IBS-C.

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Conflict of interest statement

Ethics approval and consent to participate

The following ethics committees approved the trial protocol and its amendments: Comité Consultatif sur le Traitement de l’Information en matière de Recherche dans le domaine de la Santé (Paris, France), Israelitisches Krankenhaus (Hamburg, Germany), University of Bologna (Bologna, Italy), Humanitas Hospital IRCS (Milano, Italy), Floraspe Renzetti Hospital (Lanciano, Italy), Agostino Gemelli University Hospital (Rome, Italy), University of Parma (Parma, Italy), University of Pisa (Pisa, Italy), University of Pescara (Pescara, Italy), Careggi University (Firence, Italy), University of Napoli Federico II (Napoli, Italy), University of L’Aquila (L’Aquila, Italy), University of Messina (Messina, Italy), University of Genoa (Genoa, Italy). Ospedale S. Maria di Ca′ Foncello (Treviso, Italy), Fondazione IRCCS Policlinico San Matteo (Pavia, Italy), Centro médico Teknon (Barcelona, Spain), Hospital Clínico San Carlos (Madrid, Spain), Hospital Universitario 12 de Octubre (Madrid, Spain), Hospital Germans Trias I Pujol (Badalona, Spain), Hospital de Bellvitge (Barcelona, Spain), Consorci Sanitari del Maresme (Mataró, Spain), Hospital Universitario Virgen de la Macarena (Sevilla, Spain), Hospital Universitari Doctor Josep Trueta (Girona, Spain), Hospital Universitari Sant Joan de Reus (Reus, Spain), National Institute for Health Research (London, UK).

Consent for publication

Not applicable.

Competing interests

JT receives grants and/or research support from Abbott, Novartis and Shire; honoraria and/or consultancy fees from Almirall, AstraZeneca, Danone, GI Dyamics, GlaxoSmithKline, Ironwood, Janssen, Menarini, Novartis, Rhythm, Shire, Takeda, Theravance, Tsumura, Will Pharma and Zeria; and speaker fees from Abbott, Almirall, AstraZeneca, Janssen, Menarini, Novartis, Shire, Takeda and Zeria.

VS receives grants and/or research support from Alfa Wassermann, Almirall, Aptalis, Italchimici, Norgine, Shire, Takeda, Valeas; honoraria and/or consultancy fees from Abbott, Alfa Wasserman, Almirall, Angelini, Aptalis, CM&D Pharma, Farmaderma, Ironwood, Norgine, Shire, Takeda, Valeas, Vibrant and Zeria.

FM receives speaker fees from Almirall.

YY receives grants from Shire; Medtronic; and speaker fees from Almirall, Shire, and Sucampo.

PL receives financial support from Abbott / Solvay, Almirall, Aptalis / Axcan, Norgine, and Shire.

BC receives honoraria and/or consultancy fees from Almirall, Mundipharma, Mayoly Spindler, and Menarini.

MS receives unrestricted research grants from Danone, and AstraZeneca; consultant and/or Advisory Board member fees from Danone, Nestlé, Chr Hansen, Almirall, Albireo and Shire; participation fees for company-sponsored speaker’s bureau from Almirall, Shire, Tillotts and Takeda.

JM is an employee of TFS Develop S.L, contracted by Almirall S.A to conduct the study.

GW and AM are employees of Allergan International.

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Study design
Fig. 2
Fig. 2
Mean healthcare resource utilisation costs for the (a) HS and (b) patient. * includes hospitalisations and adverse reactions
See this image and copyright information in PMC

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