Estimation the direct cost of inflammatory bowel disease in Iranian patients: the one-year follow-up

We conducted this study to estimate the direct medical cost of the Iranian IBD patients.

In the economic evaluation setting, descriptive epidemiological studies can provide substantial information for health system policymakers in taking accountable decisions for diseases such as Inflammatory Bowel Disease (IBD).

To do so, we used a self-designed checklist to collect demographic and medical cost information for IBD patients. We also tried to have a national estimation of IBD costs.

The mean annual medical cost of IBD was 18354.52 PPP$. Crohn's disease (CD) vs. ulcerative colitis (UC) and UC township patients vs. Tehran residents patients had higher medical costs (31160.79 PPP$; P<0.001) and (20840.23 PPP$, P<0.025). The most spent medical cost in both IBD subtypes (CD/UC) was attributed to biological agents, especially in UC patients. We estimated that the mean annual cost of IBD in Iran for 2017 was 746315864 (602964172, 964685749) PPP$(constant incidence) and 862776811 (697055402, 1115222835) PPP$(increment incidence) respectively. If we assume the constant incidence from 2012 to 2017 the prevalence and subsequently mean annual cost of IBD in 2017 were 66.95 per 100000 and 746315864(602964172, 964685749) PPP$. The prevalence and mean annual cost of IBD for another scenario were 77.39 per 100000 and 862776811(697055402, 1115222835) PPP$ respectively. 

Our results suggest that to the management of IBD patient's policymakers should consider shifting the medical costs to biological agents, the higher cost of CD and the impact of underlying factors on the distribution of these medical costs.