Economic impact of inflammatory bowel disease in Catalonia: a population-based analysis

Background: Inflammatory bowel disease (IBD) has a major economic impact on healthcare costs.Objectives: The aim of this study was to evaluate the current healthcare expenditure associated with IBD in a population-wide study in Catalonia.Design: Retrospective observational study.Methods: All patients with IBD included in the Catalan Health Surveillance System (CHSS) were considered eligible. The CHSS compiles data on more than 7 million individuals in 2020 (34,823 with IBD). Data on the use of healthcare resources and its economic impact were extracted applying the International Classification of Diseases, 10th revision, Clinical Modification codes (ICD-10-CM codes). Health expenditure, comorbidities, and hospitalization were calculated according to the standard costs of each service provided by the Department of Health of the Catalan government. The data on the IBD population were compared with non-IBD population adjusted for age, sex, and income level. IBD costs were recorded separately for Crohn's disease (CD) and ulcerative colitis (UC).Results: Prevalence of comorbidities was higher in patients with IBD than in those without. The risk of hospitalization was twice as high in the IBD population. The overall healthcare expenditure on IBD patients amounted to 164Meuro. The pharmacy cost represents the 60%. The average annual per capita expenditure on IBD patients was more than 3.4-fold higher (IBD 4200euro, non-IBD 1200euro). Average costs of UC were 3400euro and 5700euro for CD.Conclusion: The risk of comorbidities was twice as high in patients with IBD and their use of healthcare resources was also higher than that of their non-IBD counterparts. Per capita healthcare expenditure was approximately 3.4 times higher in the population with IBD.Trial registration: The study was not previously registered. Economic impact of inflammatory bowel disease in CataloniaThe manuscript includes data of the most recent epidemiologic data about the high economic impact of IBD in Catalonia

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

sj-png-4-tag-10.1177_17562848231222344 – Supplemental material for Economic impact of inflammatory bowel disease in Catalonia: a population-based analysis

Supplemental material, sj-png-4-tag-10.1177_17562848231222344 for Economic impact of inflammatory bowel disease in Catalonia: a population-based analysis by Eduard Brunet-Mas, Belen Garcia-Sagué, Emli Vela, Luigi Melcarne, Laura Patricia Llovet, Caridad Pontes, Pilar García-Iglesias, Anna Puy, Sergio Lario, Maria Jose Ramirez-Lazaro, Albert Villoria, Johan Burisch, Gilaad G. Kaplan and Xavier Calvet in Therapeutic Advances in Gastroenterology</p

sj-png-3-tag-10.1177_17562848231222344 – Supplemental material for Economic impact of inflammatory bowel disease in Catalonia: a population-based analysis

Supplemental material, sj-png-3-tag-10.1177_17562848231222344 for Economic impact of inflammatory bowel disease in Catalonia: a population-based analysis by Eduard Brunet-Mas, Belen Garcia-Sagué, Emli Vela, Luigi Melcarne, Laura Patricia Llovet, Caridad Pontes, Pilar García-Iglesias, Anna Puy, Sergio Lario, Maria Jose Ramirez-Lazaro, Albert Villoria, Johan Burisch, Gilaad G. Kaplan and Xavier Calvet in Therapeutic Advances in Gastroenterology</p

sj-png-1-tag-10.1177_17562848231222344 – Supplemental material for Economic impact of inflammatory bowel disease in Catalonia: a population-based analysis

Supplemental material, sj-png-1-tag-10.1177_17562848231222344 for Economic impact of inflammatory bowel disease in Catalonia: a population-based analysis by Eduard Brunet-Mas, Belen Garcia-Sagué, Emli Vela, Luigi Melcarne, Laura Patricia Llovet, Caridad Pontes, Pilar García-Iglesias, Anna Puy, Sergio Lario, Maria Jose Ramirez-Lazaro, Albert Villoria, Johan Burisch, Gilaad G. Kaplan and Xavier Calvet in Therapeutic Advances in Gastroenterology</p

sj-png-2-tag-10.1177_17562848231222344 – Supplemental material for Economic impact of inflammatory bowel disease in Catalonia: a population-based analysis

Supplemental material, sj-png-2-tag-10.1177_17562848231222344 for Economic impact of inflammatory bowel disease in Catalonia: a population-based analysis by Eduard Brunet-Mas, Belen Garcia-Sagué, Emli Vela, Luigi Melcarne, Laura Patricia Llovet, Caridad Pontes, Pilar García-Iglesias, Anna Puy, Sergio Lario, Maria Jose Ramirez-Lazaro, Albert Villoria, Johan Burisch, Gilaad G. Kaplan and Xavier Calvet in Therapeutic Advances in Gastroenterology</p

sj-png-5-tag-10.1177_17562848231222344 – Supplemental material for Economic impact of inflammatory bowel disease in Catalonia: a population-based analysis

Supplemental material, sj-png-5-tag-10.1177_17562848231222344 for Economic impact of inflammatory bowel disease in Catalonia: a population-based analysis by Eduard Brunet-Mas, Belen Garcia-Sagué, Emli Vela, Luigi Melcarne, Laura Patricia Llovet, Caridad Pontes, Pilar García-Iglesias, Anna Puy, Sergio Lario, Maria Jose Ramirez-Lazaro, Albert Villoria, Johan Burisch, Gilaad G. Kaplan and Xavier Calvet in Therapeutic Advances in Gastroenterology</p