Crohn's disease results in substantial morbidity and high use of health services.
The aim of this study was to describe the lifetime clinical course and costs of Crohn's disease in a 24-year population-based inception cohort of patients with Crohn's disease in Olmsted County, Minnesota.
Disease states were defined by medical and surgical treatment.
A Markov model analysis calculated time in each disease state and present value of excess lifetime costs in comparison with an age-and sex-matched cohort.
For a representative patient, projected lifetime costs were $39,906 per patient using median charges and $125,404 using mean charges.
There were 29.1 years (63% of total) without medications.
There were 12.7 years (27%) on aminosalicylate therapy, generating $11,467 (29%) in charges, and 3.2 years (7%) on corticosteroid or immunosuppressive therapy, generating $5147 (13%) in charges.
Surgery generated $17,526 (44%) in charges.
Most of the clinical course is spent in remission, either medical or surgical.
Aminosalicylate therapy accounts for 29% of the costs of care.
Surgery has the highest charges but the longest remissions.
Treatment strategies that induce remission in mild disease and maintain remission with lower-cost maintenance therapy will have the largest effect on patient outcomes and costs.
Mots-clés Pascal : Entérite Crohn, Coût, Traitement, Evolution, Modèle Markov, Etude cohorte, Etude statistique, Homme, Appareil digestif pathologie, Intestin pathologie, Maladie inflammatoire, Economie santé
Mots-clés Pascal anglais : Crohn disease, Costs, Treatment, Evolution, Markov model, Cohort study, Statistical study, Human, Digestive diseases, Intestinal disease, Inflammatory disease, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0413512
Code Inist : 002B30A01C. Création : 22/03/2000.