Inflammatory Bowel Diseases (Crohn´s Disease and Ulcerative Colitis): Cost of Treatment in Serbia and the Implications

Appl Health Econ Health Policy. 2017 Feb;15(1):85-93. doi: 10.1007/s40258-016-0272-z.

Abstract

Background: Although the costs of treating inflammatory bowel disease (IBD) in developed countries are well established, they remain largely unknown in countries with recent histories of socio-economic transition including Serbia.

Objective: To estimate the costs of treatment including the resources used by patients with IBD in Serbia from a societal perspective. This includes both Crohn's disease and ulcerative colitis.

Methods: This cost-of-illness study was conducted to identify direct, indirect and out-of-pocket costs of treating patients with IBD in Serbia. Patients with IBD (n = 112) completed a semi-structured questionnaire with data concerning their utilisation of heath-care resources and illness-related expenditures. All costs were calculated in Republic of Serbia dinars (RSD) at a 1-year level (2014) and subsequently converted to Euros. Median values and ranges were reported to avoid potential distortions associated with mean costs.

Results: Median total direct costs and total indirect costs per patient per year in patients with Crohn's disease were 192,614.32RSD (€1602.97) and 28,014.00RSD (€233.13) and 142,267.15RSD (€1183.97) and 21,436.00RSD (€178.39), respectively, in patients with ulcerative colitis. In both groups, the greatest component of direct costs was hospitalisation.

Conclusions: Costs of IBD in Serbia are lower than in more developed countries for two reasons. These include the fact that expensive biological therapy is currently under-utilised in Serbia and prices of health services are largely controlled by the State at a low level. The under-utilisation of biologicals may change with the advent of biosimilars at increasingly lower prices.

MeSH terms

  • Adolescent
  • Adult
  • Colitis, Ulcerative / economics*
  • Colitis, Ulcerative / therapy
  • Crohn Disease / economics*
  • Crohn Disease / therapy
  • Delivery of Health Care / economics
  • Delivery of Health Care / statistics & numerical data
  • Female
  • Financing, Personal / economics
  • Financing, Personal / statistics & numerical data
  • Health Care Costs* / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Serbia
  • Surveys and Questionnaires
  • Young Adult