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Direct Medical Cost of Managing IBD Patients: A Canadian Population-based Study

Bernstein, Charles N. MD1,2; Longobardi, Teresa PhD3,4; Finlayson, Greg BA5; Blanchard, James F. MD, PhD2,3

doi: 10.1002/ibd.21878
Original Article: Original Clinical Articles

Background: This study aimed to quantify the direct medical cost of treating inflammatory bowel disease (IBD) in Manitoba in 2005/2006.

Methods: In all, 7375 individuals with IBD recorded in the University of Manitoba IBD Epidemiology Database were matched on age, gender, and geography to up to 10 non-IBD controls. Data for cases and controls were extracted from Manitoba Health databases in fiscal 2005/2006 for pharmaceutical, physician claims, and hospital abstracts. The mean and median expenditure were computed for the annual cost of pharmaceuticals, hospitalizations (day surgery and inpatient), and physician office visits. We assessed costs based on age, gender, type of IBD, disease duration, and level of care provided.

Results: In 2005/2006 the mean direct cost of an IBD case was $3896 (standard error [SE] = $90) which was twice that of controls (P < 0.05). Crohn's disease (CD; n = 3735) was significantly more costly on average than ulcerative colitis (UC; n = 3640) ($4232; SE = $137 and $3552; SE = $117, respectively, P < 0.001). The most costly cases included those within 1 year of diagnosis ($6611; SE = $593), those hospitalized overnight (15%) ($13,495, SE = $416; max = $130,332), those who had a surgical stay (2% of IBD cases) ($18,749, range = $13,413–$125,912), and those using infliximab (0.7%) ($31,440, SE = $2311; max = $96,328). For individuals using infliximab their direct annual average healthcare cost was $9683 (SE = $1745, Max = $55,208) prior to using infliximab.

Conclusions: In Manitoba the direct average annual healthcare cost of CD is greater than UC and that of a patient using infliximab tends to be greater than one incurring a surgical stay. (Inflamm Bowel Dis 2012)

1 Department of Medicine, University of Manitoba, Winnipeg, Canada

2 University of Manitoba IBD Clinical and Research Centre, Winnipeg, Canada

3 Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada

4 University of Puerto Rico, San Juan, Puerto Rico

5 Manitoba Centre For Health Policy, Winnipeg, Canada

Reprints: Charles N. Bernstein, MD, University of Manitoba, 804F-715 McDermot Ave., Winnipeg, Manitoba, Canada R3E3P4


Received 29 July 2011; Accepted 7 August 2011

Published online 22 November 2011 in Wiley Online Library (

© Crohn's & Colitis Foundation of America, Inc.
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