Background and aims: Given the lack of data, we aimed to systematically analyze therapeutic patterns and health resource utilization in the year before inflammatory bowel disease (IBD)-related hospitalization.
Methods: Based on claims data of the Helsana health insurance group, therapy patterns and health resource utilization were assessed, and costs reimbursed by mandatory basic health insurance were calculated during a one-year period before an index hospitalization between 1 January 2013 to 31 December 2015.
Results: We analyzed 344 IBD patients (140 ulcerative colitis [40.7%], 204 Crohn's disease [59.3%]). Drug regimens applied in the year before index hospitalization were as follows: no IBD drugs (43.6% ulcerative colitis, 43.1% Crohn's disease); 5-ASA (45.7% ulcerative colitis, 19.1% Crohn's disease); local steroids (17.9% ulcerative colitis, 17.6% Crohn's disease); systemic steroids (38.6% ulcerative colitis, 29.4% Crohn's disease); immunomodulators (10.7% ulcerative colitis, 18.1% Crohn's disease); biologics (10% ulcerative colitis, 24% Crohn's disease); and calcineurin inhibitors (2.1% ulcerative colitis, 1.5% Crohn's disease). Forty-five percent of ulcerative colitis patients and 31.4% of Crohn's disease patients had no diagnostic procedures [computed tomography (CT), MRI, radiograph, sonography, colonoscopy, and calprotectin] in the year before hospitalization. Total annual health care costs before index hospitalization was EUR 4060 (interquartile range (IQR) 2360-7390) for ulcerative colitis and EUR 4900 (IQR 1520-14 880) for Crohn's disease patients, respectively.
Conclusions: Over 40% of ulcerative colitis and Crohn's disease patients did not receive any treatment in the year before index hospitalization. Efforts should be launched to timely diagnose and adequately treat IBD outpatients.