IBD Leads to High Levels of Indirect Costs in Europe

A new economic analysis shows high variability in productivity losses because of inflammatory bowel disease (IBD) between different European countries.

A team, led by Przemyslaw Holko, PhD, Department of Nutrition and Drug Research, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, compared specific aspects of the societal burden of patients with IBD in 12 European countries.

The Cost of IBD

There has been a high variability of indirect costs for IBD reported in national studies.

In the study, the investigators dispersed a questionnaire to adult patients with IBD and collected data on patient characteristics, productivity loss, and informal care.

The investigators assessed the costs of productivity loss from the social perspective and valuated the cost of absenteeism and presenteeism using the gross domestic product per worker. They also measured informal care by time inputs of relatives and friends to assist patients and valuated productivity loss among informal caregivers outside their paid work with the average wage.

They also adjusted the results for confounders and multiplicity.

The Questionnaires

Overall, 3687 patients responded to the questionnaire, 67% of which were employed.

The analysis shows regular activity impairment did not differ much between the different countries. However, there was a significant difference in informal care and productivity loss observed.

There was also no differences in indirect costs between the types of IBD across the 12 countries. The mean annual cost of absenteeism, presenteeism, and informal varied from $1,257.95 in Bulgaria to $7,946.26 in Spain, from $2,264.13 in Bulgaria to $15,302.11 in Belgium, and from $1,821.63 in Poland to $12,709.27 in Italy, respectively.

Patients in remission also had lower indirect costs by 54% (presenteeism, P <.001) or 75% (absenteeism, informal care, P <.001) compared to patients with active disease.

“The study showed a high relevance of the indirect cost of IBD in the context of economic evaluation, as well as a between-country variability of work-related impairment or informal care,” the authors wrote.

Malnutrition and IBD

One associated problem with IBD is malnutrition, which could have a significant societal cost.

In research presented during the 2022 European Crohn’s and Colitis Organisation annual meeting, investigators identified predictors for malnutrition in patients with IBD.

The team defined malnutrition using the GLIM criteria, based on the combination of phenotypic and an etiologic criterium. Malnutrition was also determined using single parameters for impaired body composition, muscle strength, or caloric intake, as well as the combination of low body mass index (BMI) and unintentional weight loss as advised in current IBD guidelines.

Of the 200 patients, 20.5% (n = 41) fulfilled the GLIM criteria and 47.5% (n = 95) had at least one parameter for malnutrition impaired, the majority of which was for the fat free mass index measure.

The study, “Indirect Costs of Inflammatory Bowel Diseases: A Comparison of Patient-Reported Outcomes Across 12 European Countries,” was published online in Inflammatory Bowel Diseases.