Paradigm Shift Of Healthcare Cost For Patients With Inflammatory Bowel Diseases: A Claims Data-Based Analysis In Japan

Anti-tumor necrosis factor-alpha (anti-TNF alpha) 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-TNF alpha 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-TNF alpha 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-TNF alpha 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-TNF alpha agents have resulted in drug costs exceeding inpatient costs for IBD. Optimized use of anti-TNF alpha agents and introduction of biosimilars for anti-TNF alpha agents can be expected to substantially reduce the health care costs of IBD.