Clinical economics review: medical management of inflammatory bowel disease

Inflammatory bowel diseases. although they are uncommon and rarely fatal. t ypically present during the period of economically productive adult life. P atients may require Extensive therapeutic intervention as a result of the c hronic. relapsing nature of the diseases. Their medical management includes oral and topical 5-amino salicylic acid derivatives and corticosteroids, a s well as antibiotics and immunosuppressive therapies, Assessing the cost-e ffectiveness of rival treatments requires valid, reliable global assessment s of outcome which consider quality of life. as well as the usual clinical end-points, Macro-economic studies of the overall impact of inflammatory bo wel disease on health care systems have so far been largely confined to Nor th America. where the total annual US costs. both direct and indirect. incu rred by the estimated 380000-480000 sufferers has been put at around US$2bn . Drugs were estimated to account for only 10% of total costs. whereas surg ery and hospitalization account for approximately half. Studies from Europe suggest that the proportion of patients with Crohn's disease and ulcerativ e colitis who are capable of full time work is 75% and 90%, respectively. H owever, whilst only a minority of inflammatory bowel disease patients suffe r chronic ill health and their life expectancy is normal. obtaining life as surance may be problematic, suggesting a misconception that inflammatory bo wel disease frequently results in a major impact on an individual's economi c productivity.