The impact of symptom severity on the humanistic and economic burden of inflammatory bowel disease: a real-world data linkage study

Abstract

Objective

Few studies have examined the association between inflammatory bowel disease (IBD) severity, and humanistic, and economic burden. We addressed this gap using a unique real-world data source that links self-reported patient data from the US National Health and Wellness Survey (NHWS) to claims data.

Methods

This cross-sectional study linked the 2015–2018 US NHWS data with medical, and pharmacy claims. Patients (≥18 years) who self-reported a physician diagnosis of IBD (ulcerative colitis [UC], or Crohn’s disease [CD]) in the NHWS, and had a medical or pharmacy claim indicating a possible diagnosis of IBD were included. Disease symptom severity was defined by a weighted symptom score and main outcomes include health-related quality of life (HRQoL), work productivity (WPAI), healthcare resource use (HRU), and associated costs.

Results

Overall, 687 patients with IBD were included, of which 347 were identified with UC and 340 with CD. Validation analysis showed that 94.7% of UC and 88.7% of patients with CD who self-reported diagnosis of CD or UC in NHWS had evidence of diagnosis and/or treatment patterns in claims. Patients with both UC and CD with moderate or severe symptoms had significantly lower HRQoL, increased work productivity loss, greater HRU, and associated costs compared with patients with mild symptoms.

Conclusions

Patients with moderate/severe UC or CD experience substantial humanistic, and economic burden compared with patients with mild UC or CD. These factors should be considered within treatment goals for patients in order to provide holistic care beyond the treatment of objective markers or disease severity and symptoms alone.

Keywords:

• Crohn’s disease
• healthcare resource use health-related quality of life work productivity ulcerative colitis

Transparency

Declaration of funding

The study was funded by Eli Lilly and Company.

Declaration of financial/other relationships

T. Hunter, A. Naegeli, and M. Shan are employees and shareholders of Eli Lilly and Company. V. Jairath has received consulting fees from AbbVie, Eli Lilly, GlaxoSmithKline, Arena Pharmaceuticals, Genetech, Pendopharm, Pfizer, Fresenius Kabi, Bristol-Myers Squibb, Roche, Ferring, Sandoz, Merck, Takeda, Janssen, Alimentiv Inc. (formerly Robarts Clinical Trials), Topivert, Celltrion; speaker’s fees from Takeda, Janssen, Shire, Ferring, Abbvie, Pfizer. LK. Lee and BL. Balkaran are employees of Kantar Health, who received funding from Eli Lilly to conduct this study. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

All authors contributed to the conception, design, and interpretation of data. B. Balkaran conducted the analysis of the data. All authors were involved in critically revising the paper, provided final approval, and agree to be accountable for all aspects of the work.

Acknowledgements

Medical writing support was provided by Shalini Vasantha, Ph.D. and Ramu Periyasamy, Ph.D. of Indegene Pvt. Ltd., India.