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Paradigm Shift of Healthcare Cost for Patients with Inflammatory Bowel Diseases: A Claims Data-Based Analysis in Japan

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Department of Health Informatics, Niigata University of Health and Welfare, Niigata 950-3198, Japan
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Department of Medical Informatics and Statistics, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8520, Japan
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Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8520, Japan
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Department of Medical Informatics, Niigata University Medical and Dental Hospital, Niigata 951-8520, Japan
*
Author to whom correspondence should be addressed.
Gastrointest. Disord. 2019, 1(1), 120-128; https://doi.org/10.3390/gidisord1010009
Received: 18 October 2018 / Revised: 7 November 2018 / Accepted: 8 November 2018 / Published: 9 November 2018
Anti-tumor necrosis factor-α (anti-TNFα) agents are used for induction and maintenance of remission in patients with inflammatory bowel diseases (IBD). However, biologic drugs present a large economic burden on health insurance systems. We aimed to estimate the mean annual health care cost per patient with IBD and cost contribution of anti-TNFα agents. We performed an analysis of patients with Crohn’s disease (CD) and ulcerative colitis (UC) based on a large-scale administrative claims database constructed by Japan Medical Data Center (JMDC) Co. Ltd., comprising inpatient, outpatient, and pharmacy claims data. We evaluated all claims from 1 April 2013 through 31 March 2016. Descriptive statistics were used to measure median health care costs paid per member per year (PMPY) and the relative cost contribution of anti-TNFα agents. A total 1405 patients with CD and 5771 with UC were included. Median costs PMPY were approximately six times higher for CD than UC (JPY 1,957,320 and JPY 278,760, respectively). Medication cost for anti-TNFα agents was the main cost driver, accounting for 59.9% and 17.8% of the total costs for CD and UC, respectively. In Japan, costs for anti-TNFα agents have resulted in drug costs exceeding inpatient costs for IBD. Optimized use of anti-TNFα agents and introduction of biosimilars for anti-TNFα agents can be expected to substantially reduce the health care costs of IBD. View Full-Text
Keywords: biosimilars; claims data; health care costs; inflammatory bowel diseases biosimilars; claims data; health care costs; inflammatory bowel diseases
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Saito, S.; Nakazawa, K.; Suzuki, K.; Ishikawa, T.; Akazawa, K. Paradigm Shift of Healthcare Cost for Patients with Inflammatory Bowel Diseases: A Claims Data-Based Analysis in Japan. Gastrointest. Disord. 2019, 1, 120-128.

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