The socioeconomic impact of irritable bowel syndrome: an analysis of direct and indirect healthcare costs.

BACKGROUND AND AIMS Irritable bowel syndrome (IBS) is associated with substantial costs to society. Extensive data on direct costs (healthcare consumption) and indirect costs (health-related productivity loss) are lacking. Hence, we examined the socioeconomic costs of IBS and assessed which patient characteristics are associated with higher costs. METHODS Cross-sectional data from three Rome-defined Dutch IBS patient cohorts (n=419) were collected. Bootstrapped mean direct and indirect costs were evaluated per IBS patient using validated questionnaires (i.e., medical cost questionnaire and productivity cost questionnaire, respectively). Multivariable regression analyses were performed to identify variables associated with higher costs. RESULTS Quarterly mean total costs per patient were €2.156 (95% CI €1793-2541, [$2.444]), consisting of €802 (€625-1010, [$909]) direct costs and €1.354 (€1072-1670, [$1535]) indirect costs. Direct costs consisted primarily of healthcare professional consultations, with costs related to gastrointestinal clinic visits accounting for 6% and costs related to mental healthcare visits for 20%. Higher direct costs were significantly associated with older age (p=0.007), unemployment (p=0.001), IBS subtypes other than constipation (p=0.033), lower disease-specific quality of life (p=0.027), and more severe depressive symptoms (p=0.001). Indirect costs consisted of absenteeism (45%), presenteeism (42%), and productivity loss related to unpaid labor (13%) and were significantly associated with the male sex (p=0.014) and more severe depressive symptoms (p=0.047). CONCLUSION Productivity loss is the main contributor to the socioeconomic burden of IBS. Direct costs were not predominantly related to gastrointestinal care, but rather to mental healthcare. Awareness of the nature of costs and contributing patient factors should lead to significant socioeconomic benefits for society.