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Increasing healthca...
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Everhov, Åsa H.Karolinska Institutet,Department of Clinical Science and Education, Södersjukhuset Karolinska Institutet Stockholm Sweden;Clinical Epidemiology Division, Department of Medicine Solna Karolinska Institutet Stockholm Sweden
(author)
Increasing healthcare costs in inflammatory bowel disease 2007-2020 in Sweden
- Article/chapterEnglish2023
Publisher, publication year, extent ...
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John Wiley & Sons,2023
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LIBRIS-ID:oai:DiVA.org:oru-107815
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https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-107815URI
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https://doi.org/10.1111/apt.17675DOI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:153522682URI
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https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-201632URI
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
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Funding agency:Kommunfullmäktige, Stockholms stad Dnr 20190638
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BACKGROUND: Inflammatory bowel disease has been linked to increasing healthcare costs, but longitudinal data on other societal costs are scarce.AIM: To assess costs, including productivity losses, in patients with prevalent Crohn's disease (CD) or ulcerative colitis (UC) in Sweden between 2007 and 2020.METHODS: We linked data from national registers on all patients with CD or UC and a matched (sex, birthyear, healthcare region and education) reference population. We assessed mean costs/year in Euros, inflation-adjusted to 2020, for hospitalisations, out-patient visits, medications, sick leave and disability pension. We defined excess costs as the mean difference between patients and matched comparators.RESULTS: Between 2007 and 2020, absolute mean annual societal costs in working-age (18-64 years) individuals decreased by 17% in CD (-24% in the comparators) and by 20% in UC (-27% in comparators), due to decreasing costs from sick leave and disability, a consequence of stricter sick leave regulations. Excess costs in 2007 were dominated by productivity losses. In 2020, excess costs were mostly healthcare costs. Absolute and excess costs increased in paediatric and elderly patients. Overall, costs for TNF inhibitors/targeted therapies increased by 274% in CD and 638% in UC, and the proportion treated increased from 5% to 26% in CD, and from 1% to 10% in UC.CONCLUSION: Between 2007 and 2020, excess costs shifted from productivity losses to direct healthcare costs; that is, the patients' compensation for sickness absence decreased, while society increased its spending on medications. Medication costs were driven both by expanding use of TNF inhibitors and by high costs for newer targeted therapies.
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Söderling, JonasKarolinska Institutet,Clinical Epidemiology Division, Department of Medicine Solna Karolinska Institutet Stockholm Sweden
(author)
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Befrits, GustafRegion Stockholm, Stockholm, Sweden
(author)
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Khalili, HamedClinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Gastroenterology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
(author)
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Bröms, GabriellaClinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Gastroenterology Unit, Danderyd Hospital, Stockholm, Sweden
(author)
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Neovius, MartinKarolinska Institutet,Clinical Epidemiology Division, Department of Medicine Solna Karolinska Institutet Stockholm Sweden
(author)
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Askling, JohanKarolinska Institutet,Clinical Epidemiology Division, Department of Medicine Solna Karolinska Institutet Stockholm Sweden
(author)
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Halfvarson, Jonas,1970-Örebro universitet,Institutionen för medicinska vetenskaper,Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden(Swepub:oru)jshn
(author)
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Ludvigsson, Jonas F.,1969-Karolinska Institutet,Department Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden;Department of Pediatrics Örebro University Hospital, Örebro University Örebro Sweden(Swepub:oru)jsln
(author)
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Olén, OlaKarolinska Institutet,Clinical Epidemiology Division, Department of Medicine Solna Karolinska Institutet Stockholm Sweden;Department of Pediatric Gastroenterology and Nutrition Sachs' Children and Youth Hospital Stockholm Sweden
(author)
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SWIBREG study group, -
(contributor)
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Myrelid, Pär,1970-Linköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Kirurgiska kliniken US,SWIBREG study group(Swepub:liu)parmy24
(contributor)
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Karolinska InstitutetDepartment of Clinical Science and Education, Södersjukhuset Karolinska Institutet Stockholm Sweden;Clinical Epidemiology Division, Department of Medicine Solna Karolinska Institutet Stockholm Sweden
(creator_code:org_t)
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In:Alimentary Pharmacology and Therapeutics: John Wiley & Sons58:7, s. 692-7030269-28131365-2036
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Everhov, Åsa H.
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Söderling, Jonas
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Befrits, Gustaf
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Khalili, Hamed
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Bröms, Gabriella
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Neovius, Martin
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Askling, Johan
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Halfvarson, Jona ...
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Ludvigsson, Jona ...
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Olén, Ola
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SWIBREG study gr ...
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