Annual cost of care for Crohn's disease: a payor perspective.

Abstract

The aim of this study was to estimate the annual cost of care of patients with Crohn's disease according to treatment setting. Using a 1994 integrated claims database, patients with a Crohn's-related medical claim (ICD-9 code 555) from 10/01/94 to 09/30/95 were included in this analysis. These patients were stratified into three mutually exclusive disease severity groups: group 1, required hospitalization for Crohn's; group 2, required chronic glucocorticoid or immunosuppressive drug therapy for >6 months; group 3, all remaining patients. Direct charges (based on reimbursement) and utilization of resources were reported for each group. Six-hundred-seven patients were analyzed: 117(19%) in group 1, 31(5%) in group 2, and 459(76%) in group 3. Average age of all patients was 48 years and 43% of these patients were men. Average annual charges for all patients totaled $12,417. Group I patients experienced the highest mean charges ($37,135), whereas patients in groups 2 and 3 incurred $10,033 and $6,277. Approximately 25% of patients accounted for 80% of the total charges. Crohn's disease is associated with high cost. Although a minority of Crohn's patients required hospitalization, they tended to have higher utilization and were responsible for a majority of total expenditures. New therapies have the potential to reduce overall cost of care, if they prevent Crohn's-related hospitalizations.