Healthcare costs of inflammatory bowel disease have shifted from hospitalisation and surgery towards anti-TNFα therapy: results from the COIN study.

M.E. van der Valk, M. J. Mangen, M Leenders, G. Dijkstra, A.A. van Bodegraven, H. H. Fidder, D.J. de Jong, M.J. Pierik, C.J. van der Woude, M. Romberg-Camps, C.H. Clemens, J.M. Jansen, N. Mahmmod, P. C. van de Meeberg, A. E. van der Meulen Jong, C. Y. Ponsioen, C. J. Bolwerk, J. R. Vermeijden, P.D. Siersema, MG Van OijenB. Oldenburg*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


OBJECTIVE: The introduction of anti tumour necrosis factor-alpha (anti-TNFalpha) therapy might impact healthcare expenditures, but there are limited data regarding the costs of inflammatory bowel diseases (IBD) following the introduction of these drugs. We aimed to assess the healthcare costs and productivity losses in a large cohort of IBD patients. DESIGN: Crohn's disease (CD) and ulcerative colitis (UC) patients from seven university hospitals and seven general hospitals were invited to fill-out a web-based questionnaire. Cost items were derived from a 3 month follow-up questionnaire and categorised in outpatient clinic, diagnostics, medication, surgery and hospitalisation. Productivity losses included sick leave of paid and unpaid work. Costs were expressed as mean 3-month costs per patients with a 95% CI obtained using non-parametric bootstrapping. RESULTS: A total of 1315 CD patients and 937 UC patients were included. Healthcare costs were almost three times higher in CD as compared with UC, euro1625 (95% CI euro1476 to euro1775) versus euro595 (95% CI euro505 to euro685), respectively (p<0.01). Anti-TNFalpha use was the main costs driver, accounting for 64% and 31% of the total cost in CD and UC. Hospitalisation and surgery together accounted for 19% and <1% of the healthcare costs in CD and 23% and 1% in UC, respectively. Productivity losses accounted for 16% and 39% of the total costs in CD and UC. CONCLUSIONS: We showed that healthcare costs are mainly driven by medication costs, most importantly by anti-TNFalpha therapy. Hospitalisation and surgery accounted only for a minor part of the healthcare costs.
Original languageEnglish
Pages (from-to)72-79
Number of pages8
Issue number1
Publication statusPublished - 1 Jan 2014


  • Inflammatory Bowel Disease
  • Crohn's Disease
  • Ulcerative Colitis
  • Economic Evaluation

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