IBS with Constipation Has Large Economic Effect on Healthcare Systems, Patients

Irritable bowel syndrome with predominant constipation (IBS-C) is a complex disorder that has a large economic effect on healthcare systems and society, according to the results of an economic study published in BMC Gastroenterology. This economic impact highlights a need for greater understanding of patients with severe IBS-C, and a move away from a one-size-fits-all approach.

“Given the symptom and severity complexities of IBS-C there is a notable paucity of information related to health economic burden and resource utilization, especially in sufferers at the more severe end of the severity spectrum,” explained study researcher Jan Tack, of the University Hospital Gasthuisberg, Leuven, Belgium, and colleagues. “Newer agents approved to treat IBS-C may potentially decrease the need for frequent visits to physicians and multiple medications, possibly translating into lower healthcare utilization and drug-related costs.”

To study these things, Tack and colleagues conducted a 1-year retrospective-prospective study of 525 patients diagnosed with IBS-C in the last 5 years with moderate to severe disease at inclusion. Patients were from six different European countries.

Baseline and retrospective data were obtained from medical records and patient interviews. IBS symptom severity scores (SSS) were obtained at baseline and 6 months. Sixty-percent of included patients has severe IBS-C.

During the follow-up period, between 11.1% and 24.0% of patients were hospitalized or had an emergency department visit, with a median stay of between 1.5 and 12.0 days. Additionally, between 41.1% and 90.4% of patients took prescription drugs because of their disorders.

IBS-C also resulted in missed worked. Between almost one-quarter to one-half (21.4% to 50.8%) of employed patients had to take sick leave from work.

“Overall, patients in this cohort reported a high frequency of symptoms that led to substantial direct and indirect costs for healthcare systems and society,” the researchers wrote.

The researchers calculated that the mean annual direct cost to the healthcare system of these patients was between €937.1 to €2,108.0 (~$1,043 to $2,347.14). The total direct cost for the healthcare system and patients combined was €1,421.7 to €2,487.1 (~$1,582.98 to $2,769.25). Hospitalizations and emergency department visits were the largest cost driver, according to the study.

“Costs attributable to hospitalizations/ER visits in this study were higher than that reported for IBS patients in general,” the researchers wrote. “This finding is related to the predominantly severe IBS-C population of this study and suggests that patients with more severe IBS-C may require more inpatient care.”

Tack J, Stanghellini V, Mearin F, et al. Economic burden of moderate to severe irritable bowel syndrome with constipation in six European countries. BMC Gastroenterol. 2019;19:69. Doi:10.1186/s12876-019-0985-1.