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. 2022 Jun 15;30(4):283-292.
doi: 10.1159/000525206. eCollection 2023 Aug.

Burden of Disease and Cost of Illness of Inflammatory Bowel Diseases in Portugal

Fernando Magro  1   2   3   4 , Francisco Portela  2   5 , Paula Lago  2   6 , Cristina Chagas  2   7 , Francisco Moreira  8 , Fábio Pereira  8 , Bernardo Rodrigues  9 , Hugo Pedrosa  8 , Luis Correia  2   10
Affiliations

Burden of Disease and Cost of Illness of Inflammatory Bowel Diseases in Portugal

Fernando Magro et al. GE Port J Gastroenterol. .

Abstract
in English, Portuguese

Background: Inflammatory bowel diseases' (IBD) increasing incidence and prevalence place a heavy health and economic burden on society.

Objectives: This study assesses the burden and cost of IBD in Portugal to support the definition of health policies, resource allocation, and patient care.

Methods: The burden of disease was expressed using disability-adjusted life years (DALY). Costs were estimated considering the societal perspective, using a prevalence-based model and prices established by law. An expert panel composed of 5 expert Portuguese gastroenterologists and a patient-reported study were conducted to support the cost analysis and fill in information gaps.

Results: In Portugal, with a prevalence of 24,069 IBD patients and an incidence of 15/100,000, the burden of disease was estimated at 6,067 DALYs: 507 resulting from premature deaths and 5,560 from disability. Total cost was estimated at EUR 146 million per year, with direct costs representing 59%. Average yearly cost per IBD patient is EUR 6,075, where 60% is related to Crohn's disease and 40% to ulcerative colitis (UC).

Conclusion: This study estimates the annual health burden and cost of IBD in Portugal, thus generating information with the intent to raise awareness of the need to advance health policies as well as better clinical and economic decisions in this pathology.

Contexto: A crescente incidência e prevalência das Doenças Inflamatórias Intestinais (DII) representam um pesado fardo para a saúde e economia na sociedade.

Objetivos: Este estudo avalia o custo e a carga da DII em Portugal, com o objetivo de suportar a definição de políticas de saúde, alocação de recursos e cuidados com o doente.

Métodos: A carga da doença foi calculada utilizando anos de vida ajustados à incapacidade (DALY). Os custos foram estimados tendo em conta a perspetiva da sociedade, utilizando um modelo baseado na prevalência e preços estabelecidos por lei. Foi realizado um painel de peritos, composto por 5 gastroenterologistas portugueses, assim como um estudo de mercado a doentes, de forma a suportar a análise de custos e colmatar lacunas de informação.

Resultados: Em Portugal, com uma prevalência de 24,069 doentes e uma incidência de 15/100,000, o peso das DII foi estimado em 6.067 DALYs: 507 dos quais resultantes de mortes prematuras e 5.560 de incapacidade. O custo total foi estimado em 146 milhões de euros por ano, com os custos diretos a representarem 59% do total. O custo médio anual por doente de DII é de 6.075 EUR, onde 60% está relacionado com Doença de Crohn (DC) e 40% com Colite Ulcerosa.

Conclusão: Este estudo estima os encargos anuais para a saúde e o custo da DII em Portugal, gerando informação relevante, com o intuito de alertar para a necessidade de uma evolução nas políticas de saúde, assim como como suportar melhores decisões clínicas e económicas nesta patologia.

Keywords: Burden of disease; Cost of illness; Crohn's disease; Inflammatory bowel disease; Ulcerative colitis.

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Conflict of interest statement

Fernando Magro, Francisco Portela, Paula Lago, Cristina Chagas, and Luis Correia received honoraria from Janssen for participation in expert panel. Bernardo Rodrigues is an employee of Janssen Portugal. Francisco Moreira, Fábio Pereira, and Hugo Pedrosa are employees of IQVIA Portugal and were contracted by Janssen Portugal for the development of this article.

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