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Irritable bowel syndrome in Germany. A cost of illness study

Müller-Lissner, Stefan Aa; Pirk, Olafb

European Journal of Gastroenterology & Hepatology: December 2002 - Volume 14 - Issue 12 - p 1325-1329
Original Articles: Irritable bowel syndrome

Objectives  When asked, between 10% and 15% of people in the Western world report symptoms compatible with irritable bowel syndrome, and around 5% seek medical advice for these complaints. This should incur considerable costs. The present study was designed to give a cost estimate for the treatment of patients with irritable bowel syndrome paid for by German statutory health insurance.

Methods  Fifty doctors working in private practice were randomly selected to each carry out personal interviews on four irritable bowel syndrome patients chosen from their own records (total 200 patients). Using a structured questionnaire, information regarding diagnostic procedures, drugs and other therapies, hospitalization and days off work were obtained from the case records. To calculate the total direct costs of the illness, all single cost elements such as physician services, medication and hospitalization were included.

Results  The number of office visits was nine per patient per year; nearly one-third of employed patients missed work for irritable bowel syndrome, and one out of 15 patients was hospitalized for this condition. Several technical procedures were ordered, mostly laboratory tests. Nearly all patients had at least one drug prescription for irritable bowel syndrome during the year of the survey, with a mean of 3.5 prescriptions per patient. The largest pharmacological groups were antispasmodics (29.2%) and prokinetics (8.9%). Total direct costs for one irritable bowel syndrome patient per year amounted to 1548 DEM (791.48 €), comprising roughly 25% for physician visits and tests, 50% for drugs and 25% for hospitalization. Including indirect costs for sick leave, total costs were 1946 DEM (994.97 €) per patient per year.

Conclusions  The costs incurred by irritable bowel syndrome are considerable.

aHumboldt University Berlin, Abteilung Innere Medizin, Park-Klinik Weissensee, Berlin and bFricke & Pirk GmbH, Nürnberg, Germany

Correspondence to Stefan Müller-Lissner MD, Park-Klinik Weissensee, Schönstr. 80, 13086 Berlin, Germany Tel: +49 30 9628 3600; fax: +49 30 9628 3605; e-mail:

Sponsorship: This study was supported by a research grant from Novartis Pharma GmbH, Germany.

Received 1 November 2001 Revised 26 February 2002 Accepted 23 July 2002

© 2002 Lippincott Williams & Wilkins, Inc.