The cost of inflammatory bowel disease in high-income settings: a Lancet Gastroenterology & Hepatology Commission

Johan Burisch*, Mirabella Zhao, Selwyn Odes, Peter De Cruz, Severine Vermeire, Charles N. Bernstein, Gilaad G. Kaplan, Dana Duricova, Dan Greenberg, Hans O. Melberg, Mamoru Watanabe, Hyeong Sik Ahn, Laura Targownik, Valérie E.H. Pittet, Vito Annese, K. T. Park, Konstantinos H. Katsanos, Marte L. Høivik, Zeljko Krznaric, María ChaparroEdward V. Loftus, Peter L. Lakatos, Javier P. Gisbert, Willem Bemelman, Bjorn Moum, Richard B. Gearry, Michael D. Kappelman, Ailsa Hart, Marieke J. Pierik, Jane M. Andrews, Siew C. Ng, Renata D'Inca, Pia Munkholm

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskriftReviewForskningpeer review

59 Citationer (Scopus)
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Abstract

The cost of caring for patients with inflammatory bowel disease (IBD) continues to increase worldwide. The cause is not only a steady increase in the prevalence of Crohn's disease and ulcerative colitis in both developed and newly industrialised countries, but also the chronic nature of the diseases, the need for long-term, often expensive treatments, the use of more intensive disease monitoring strategies, and the effect of the diseases on economic productivity. This Commission draws together a wide range of expertise to discuss the current costs of IBD care, the drivers of increasing costs, and how to deliver affordable care for IBD in the future. The key conclusions are that (1) increases in health-care costs must be evaluated against improved disease management and reductions in indirect costs, and (2) that overarching systems for data interoperability, registries, and big data approaches must be established for continuous assessment of effectiveness, costs, and the cost-effectiveness of care. International collaborations should be sought out to evaluate novel models of care (eg, value-based health care, including integrated health care, and participatory health-care models), as well as to improve the education and training of clinicians, patients, and policy makers.
OriginalsprogEngelsk
TidsskriftThe Lancet Gastroenterology and Hepatology
Vol/bind8
Udgave nummer5
Sider (fra-til)458-492
Antal sider35
ISSN2468-1253
DOI
StatusUdgivet - 2023

Bibliografisk note

Funding Information:
Figure 1 was created with the aid of a grant (number G-2108-04777) from The Leona M and Harry B Helmsley Charitable Trust.

Funding Information:
Rates of participation in the audit process increased from around 76% in the first audit round to more than 95% by the end of the process. How was this done? Each hospital had a lead clinician to take responsibility and the Chief Executive of the hospital was kept informed of the process. The teams were engaged throughout the process with regular feedback, and involvement of the national charity and gastroenterology society ensured widespread dissemination of its results. The programme initially received funding from the Health Foundation, followed later by NHS funding of around £2 million over the 12-year project, equating to around £115 per patient in the audit. The initiative has been adopted by other countries such as the Netherlands, Australia, and New Zealand.

Publisher Copyright:
© 2023 Elsevier Ltd

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