Estimating Benefits of Therapy in Crohn’s Disease in Terms of Indirect Costs

Health economic studies in Crohn’s disease have generally estimated direct costs that are predominantly driven by hospitalization and surgery. Surgery and hospitalization account for approximately one-half of the direct costs (1). Eighty per cent of the societal costs of managing Crohn’s disease are due to the 20% of the sufferers who are most severely affected. Introduction of monoclonal antibodies to treat Crohn’s disease has increased the medical costs of management of Crohn’s disease, but this may be offset by reduction of hospitalization and surgery. The Canadian data published from Manitoba predates the introduction and widespread use of biologics (2). However, indirect costs of Crohn’s disease are less often estimated prospectively in the context of therapy. Economic analysis needs to be country specific because it is dependent on disease factors, health care costs, employment climate and wages, and societal attitude to chronic illness.