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Health Care Expenditures in Ulcerative Colitis: The Perspective of a Self-Insured Employer

Hillson, Eric PhD; Dybicz, Sharon PharmD; Waters, Heidi C. MBA; Stuart, Bruce PhD; Schaneman, Justin MS; Dabbous, Omar MD; Erwin, W Gary PharmD; Kersh, Andrew BS; Broussard, Delma MD

Journal of Occupational and Environmental Medicine: August 2008 - Volume 50 - Issue 8 - p 969-977
doi: 10.1097/JOM.0b013e31816fd663
Original Articles

Objective: This study was designed to investigate the incidence, prevalence, treatment patterns, disease severity, and direct costs associated with ulcerative colitis (UC) for claimants in health plans offered by a large self-insured employer in the United States.

Methods: Retrospective analysis of medical claims with and without UC identified from a population of approximately 500,000 employees, retirees, and dependents.

Results: Costs for UC claimants were more than twice those for the comparator group ($14,486 vs $6158; P < 0.005). Total health care costs for the severe disease cohort were double those of the mild or moderate cohorts ($26,875 vs $12,154 and $12,731), as were inpatient costs ($13,516 vs $3235 and $2244). The annual incremental cost of treating severe disease was $6812 (P < 0.005) compared with mild UC.

Conclusion: UC is a significant predictor of increased medical costs with severe disease, driven mainly by inpatient costs.

From Centocor, Inc. (Drs Hilson, Broussard, Ms Waters), Horsham, PA; Omnicare Senior Health Outcomes, LLC (Drs Dybicz, Erwin), King of Prussia, PA; the Peter Lamy Center on Drug Therapy and Aging (Dr Stuart), University of Maryland School of Pharmacy, Baltimore, MD; Human Capital Management Services (Mr Schaneman), Cheyenne, WY; TAP Pharmaceutical Products, Inc. (Dr Dabbous), Lake Forest, IL; and Options and Choices (Mr Kersh), Cheyenne, WY.

Address correspondence to: Eric Hillson, PhD, 126 West Broadway, Gettysburg, PA 17325; E-mail:

Copyright © 2008 by the American College of Occupational and Environmental Medicine