Assessment of direct costs attributed to the clinical management of children with inflammatory bowel disease in New Zealand.

OBJECTIVES

The clinical management of children with inflammatory bowel disease (IBD) incurs a substantial economic burden. No recent data are available for costs within New Zealand, thereby hindering appropriate allocation of resources. The aim of this study was to assess direct health-care costs for children with IBD in the South Island of New Zealand.

METHODS

This retrospective study included children with IBD managed at Christchurch Hospital (2018-2021), with a minimum 12-month follow-up. All IBD-related clinical events were assigned unit costs in New Zealand Dollars (NZD) as well as an equivalent in United States dollars (USD) and Euro (€). Per-patient costs were estimated using follow-up duration. Nonparametric analysis examined associations with independent variables.

RESULTS

Seventy-five children were included: mean age 12.4 years (standard deviation 3.1), 34 (45%) female, 63 (84%) with Crohn's disease (CD). Overall, there were ≈150 person-years of follow-up incurring total costs of $3,107,073 ($1,864,857 USD, €1,598,042). The median annual cost per child was $13,674 (interquartile range $7220-$27,714), ($8209 USD, €7034). Biologic drugs and related costs contributed most to expenditure (64%). There was no difference in annual costs between those with CD (median $14,360 [8621 USD, €7388]) and ulcerative colitis/IBD-unclassified (median $13,194 [$7920 USD, €6788]) or for any cost category (all p > 0.05). Annual costs were higher for those receiving biologics (p < 0.001), but being on biologics did not influence other cost categories. Higher outpatient and investigation costs were associated with shorter time since diagnosis (p < 0.001).

CONCLUSIONS

There was wide variation in annual per-patient costs for IBD management in this group with a consistent cost driver being biologic associated expenditure. This data contributes to the wider evidence base that drug costs are the primary driver of hospital care expenditure.