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. 2022 Mar 2;28(3):364-372.
doi: 10.1093/ibd/izab074.

Trends in U.S. Health Care Spending on Inflammatory Bowel Diseases, 1996-2016

Siddharth Singh  1   2 , Alexander S Qian  1 , Nghia H Nguyen  1 , Stephanie K M Ho  3 , Jiyu Luo  4 , Vipul Jairath  5   6 , William J Sandborn  1 , Christopher Ma  7   8
Affiliations

Trends in U.S. Health Care Spending on Inflammatory Bowel Diseases, 1996-2016

Siddharth Singh et al. Inflamm Bowel Dis. .

Abstract

Background: Inflammatory bowel diseases (IBD) are rising in prevalence and are associated with high health care costs. We estimated trends in U.S. health care spending in patients with IBD between 1996 and 2016.

Methods: We used data on national health care spending developed by the Institute for Health Metrics and Evaluations for the Disease Expenditure Project. We estimated corresponding U.S. age-specific prevalence of IBD from the Global Burden of Diseases Study. From these 2 sources, we estimated prevalence-adjusted, temporal trends in U.S. health care spending in patients with IBD, stratified by age groups (<20 years, 20-44 years, 45-64 years, ≥65 years) and by type of care (ambulatory, inpatient, emergency department [ED], pharmaceutical prescriptions, and nursing care), using joinpoint regression, expressed as an annual percentage change (APC) with 95% confidence intervals.

Results: Overall, annual U.S. health care spending on IBD increased from $6.4 billion (95% confidence interval, 5.7-7.4) in 1996 to $25.4 billion (95% confidence interval, 22.4-28.7) in 2016, corresponding to a per patient increase in annual spending from $5714 to $14,033. Substantial increases in per patient spending on IBD were observed in patients aged ≥45 years. Between 2011 and 2016, inpatient and ED care accounted for 55.8% of total spending and pharmaceuticals accounted for 19.9%, with variation across age groups (inpatient/ED vs pharmaceuticals: ages ≥65 years, 57.6% vs 11.2%; ages 45-64 years, 49.5% vs 26.9%; ages 20-44 years, 59.2% vs 23.6%).

Conclusions: Even after adjusting for rising prevalence, U.S. health care spending on IBD continues to progressively increase, primarily in middle-aged and older adults, with unplanned health care utilization accounting for the majority of costs.

Keywords: Crohn disease; colitis; costs; expenses; value-based care.

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Figures

Figure 1.
Figure 1.
Trends in overall spending in patients with IBD by changes in prevalence of IBD.
Figure 2.
Figure 2.
Trends in overall spending in patients with IBD ages < 20 years and ages 20-44 years with corresponding change in prevalence of IBD.
Figure 3.
Figure 3.
Trends in overall spending in patients with IBD ages 45-64 years and ages ≥65 years with corresponding change in prevalence of IBD.
Figure 4.
Figure 4.
Patterns of health care spending in patients with IBD by age and over time.
See this image and copyright information in PMC

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