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Medical resource utilization and associated costs in patients with ulcerative colitis in the UK: a chart review analysis

Bodger, Keitha; Yen, Linnettec,*; Szende, Agotab; Sharma, Gunjand; Chen, Yaozhu J.d; McDermott, Johnd; Hodgkins, Paulc

European Journal of Gastroenterology & Hepatology: February 2014 - Volume 26 - Issue 2 - p 213–221
doi: 10.1097/
Original Articles: Inflammatory Bowel Disease

Objective Limited evidence is available on the economic burden of ulcerative colitis (UC) in the UK, particularly relating to the impact of relapse frequency on direct medical costs. This study identifies and assesses medical resource utilization (MRU) and associated direct costs in mild and moderate UC patients in the UK.

Patients and methods A retrospective chart review of patients with mild-to-moderate UC diagnosed at least 1 year before the study was performed. From 33 general practitioner (GP) and 34 gastroenterologist sites, charts of the last three UC patients fulfilling the inclusion criteria were reviewed. Descriptive statistics were calculated for MRU and 2011 costs (GB£) by number of relapses.

Results The study population included 201 patients with a mean age of 39.9 years; 44% were women and the mean disease duration was 7.4 years. UC-related costs of each MRU category increased with the number of relapses. Comparing patients without relapse with those with more than two relapses, the mean annual UC-related costs were £14 versus £2556 for hospitalizations; £218 versus £988 for visits (including nurse, GP, specialist, and other visits); £21 versus £1303 for procedures; £17 versus £188 for diagnostics; and £1168 versus £6660 for all-cause total costs. Age, sex, and site of data reporting (GP vs. gastroenterologist) were not associated with MRU or costs.

Conclusion Patients with mild-to-moderate UC incurred considerable costs that increased markedly with the number of relapses. These findings support the importance of maintenance therapies in UC that reduce or prevent relapses. Quantifying the relationship between relapse rate and costs will inform future health economic studies.

aGastroenterology Department, Digestive Diseases Centre, Aintree University Hospital, Institute of Translational Medicine, University of Liverpool, Liverpool

bCovance, Leeds, UK

cShire, Wayne, Pennsylvania

dCovance, Gaithersburg, Maryland, USA

* Deceased.

Correspondence to Keith Bodger, MBChB (Hons), MD, Gastroenterology Department, Digestive Diseases Centre, Aintree University Hospital, Longmoor Lane, Liverpool L9 7AL, UK Tel/fax: +44 151 529 2809; e-mail:

Received February 23, 2013

Accepted September 3, 2013

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins