TY - JOUR
T1 - The Socioeconomic Impact of Irritable Bowel Syndrome
T2 - An Analysis of Direct and Indirect Health Care Costs
AU - Bosman, Michelle H.M.A.
AU - Weerts, Zsa Zsa R.M.
AU - Snijkers, Johanna T.W.
AU - Vork, Lisa
AU - Mujagic, Zlatan
AU - Masclee, Ad A.M.
AU - Jonkers, Daisy M.A.E.
AU - Keszthelyi, Daniel
N1 - Funding Information:
Conflicts of interest These authors disclose the following: Part of the work of Michelle Bosman is financed by EU grant H2020 DISCOvERIE/848228. Zsa Zsa Weerts has received funding from WillPharma to attend a scientific meeting. Zlatan Mujagic reports grants from Niels Stensen Fellowship, MLDS, and Galapagos. Ad Masclee reports grants from the Dutch Cancer Society. Part of the work of Daisy Jonkers is financed by Public-Private partnerships Grants of Top Knowledge Institute ‘Well on Wheat’ and ‘Well on Wheat 2.0,’ by the Carbokinetics program as part of the NWO-CCC Partnership Program, by Organic A2BV/Mothersfinest BV, by EU grants FP7 SysmedIBD/305564, BIOM/305479, and Character/305676, COST action GENIEUR, and H2020 DISCOvERIE/848228. Daniel Keszthelyi reports research funding from Grunenthal, Allergan, Will Pharma, UEG, MLDS, Rome Foundation, ZonMw, and Horizon 2020, and has received speaker’s fee (paid to host institution) from Dr Falk. The remaining authors disclose no conflicts.
Funding Information:
Funding There was no direct funding for this study. Funding for the PERSUADE study and FORTITUDE study was provided by grants received from ZonMw, The Netherlands Organization for Health Research and Development, number 836031017 and 852001924 respectively. In addition, the PERSUADE study was co-funded by WillPharma S.A., Wavre, Belgium. The commercial party had no role in the study design, data analysis/reporting, or drafting the manuscript. The MIBS cohort was in part funded by a grant from the Top Institute of Food and Nutrition, Wageningen, The Netherlands.
Funding Information:
The authors thank the PERSUADE working group (Ben Witteman, Cees Clemens, Jacobus Brouwers, Henderik Frijlink, Jean Muris, Niek De Wit, Andrea Bours, Marielle Oosterveer, Lieneke Homans, Alina van de Vendel, Annieke de Ruiter-van der Ploeg, Audrey Westendorp, Brigitte Essers), the FORTITUDE working group (Annieke de Ruiter, Bertram Haarhuis, Ben Witteman, Nikolien Pijnenborg, Laurens van der Waaij), and the MIBS working group (Martine Hesselink, Carsten Leue, Joanna Kruimel, Jean Muris, Jose Conchillo). The authors thank the patients who participated in the PERSUADE study, the FORTITUDE study, and the MIBS cohort. Michelle Bosman, MD (Conceptualization: Equal; Data curation: Equal; Formal analysis: Lead; Methodology: Equal; Project administration: Lead; Writing – original draft: Lead), Zsa Zsa Weerts (Conceptualization: Equal; Data curation: Equal; Methodology: Lead; Writing – original draft: Equal; Data collection: Equal), Johanna Snijkers (Writing – review & editing: Equal; Data collection: Equal), Lisa Vork (Writing – review & editing: Equal; Data collection: Equal), Zlatan Mujagic (Writing – review & editing: Equal), Ad Masclee (Writing – review & editing: Equal), Daisy Jonkers (Writing – review & editing: Equal), Daniel Keszthelyi (Conceptualization: Lead; Methodology: Supporting; Supervision: Lead; Writing – review & editing: Lead)
Publisher Copyright:
© 2023 AGA Institute
PY - 2023/9
Y1 - 2023/9
N2 - Background & Aims: Irritable bowel syndrome (IBS) is associated with substantial costs to society. Extensive data on direct costs (health care consumption) and indirect costs (health-related productivity loss) are lacking. Hence, we examined the socioeconomic costs of IBS and assessed which patient characteristics are associated with higher costs. Methods: Cross-sectional data from 3 Rome-defined Dutch IBS patient cohorts (n = 419) were collected. Bootstrapped mean direct and indirect costs were evaluated per patient with IBS using validated questionnaires (ie, medical cost questionnaire and productivity cost questionnaire, respectively). Multivariable regression analyses were performed to identify variables associated with higher costs. Results: Quarterly mean total costs per patient were €2.156 (95% confidence interval (CI), €1793–€2541 [$2444]), consisting of €802 (95% CI, €625–€1010 [$909]) direct costs and €1.354 (95% CI, €1072–€1670 [$1535]) indirect costs. Direct costs consisted primarily of health care professional consultations, with costs related to gastrointestinal clinic visits accounting for 6% and costs related to mental health care visits for 20%. Higher direct costs were significantly associated with older age (P =.007), unemployment (P =.001), IBS subtypes other than constipation (P =.033), lower disease-specific quality of life (P =.027), and more severe depressive symptoms (P =.001). Indirect costs consisted of absenteeism (45%), presenteeism (42%), and productivity loss related to unpaid labor (13%) and were significantly associated with the male sex (P =.014) and more severe depressive symptoms (P =.047). Conclusions: Productivity loss is the main contributor to the socioeconomic burden of IBS. Direct costs were not predominantly related to gastrointestinal care, but rather to mental health care. Awareness of the nature of costs and contributing patient factors should lead to significant socioeconomic benefits for society.
AB - Background & Aims: Irritable bowel syndrome (IBS) is associated with substantial costs to society. Extensive data on direct costs (health care consumption) and indirect costs (health-related productivity loss) are lacking. Hence, we examined the socioeconomic costs of IBS and assessed which patient characteristics are associated with higher costs. Methods: Cross-sectional data from 3 Rome-defined Dutch IBS patient cohorts (n = 419) were collected. Bootstrapped mean direct and indirect costs were evaluated per patient with IBS using validated questionnaires (ie, medical cost questionnaire and productivity cost questionnaire, respectively). Multivariable regression analyses were performed to identify variables associated with higher costs. Results: Quarterly mean total costs per patient were €2.156 (95% confidence interval (CI), €1793–€2541 [$2444]), consisting of €802 (95% CI, €625–€1010 [$909]) direct costs and €1.354 (95% CI, €1072–€1670 [$1535]) indirect costs. Direct costs consisted primarily of health care professional consultations, with costs related to gastrointestinal clinic visits accounting for 6% and costs related to mental health care visits for 20%. Higher direct costs were significantly associated with older age (P =.007), unemployment (P =.001), IBS subtypes other than constipation (P =.033), lower disease-specific quality of life (P =.027), and more severe depressive symptoms (P =.001). Indirect costs consisted of absenteeism (45%), presenteeism (42%), and productivity loss related to unpaid labor (13%) and were significantly associated with the male sex (P =.014) and more severe depressive symptoms (P =.047). Conclusions: Productivity loss is the main contributor to the socioeconomic burden of IBS. Direct costs were not predominantly related to gastrointestinal care, but rather to mental health care. Awareness of the nature of costs and contributing patient factors should lead to significant socioeconomic benefits for society.
KW - Health Care Cost
KW - IBS
KW - Socioeconomic Burden
U2 - 10.1016/j.cgh.2023.01.017
DO - 10.1016/j.cgh.2023.01.017
M3 - Article
C2 - 36731587
SN - 1542-3565
VL - 21
SP - 2660
EP - 2669
JO - Clinical gastroenterology and hepatology
JF - Clinical gastroenterology and hepatology
IS - 10
ER -