Published: 03-12-2024 10:33 | Updated: 03-12-2024 10:40

Epidemiology and health economics in gastrointestinal diseases

A new thesis from Karolinska Institutet shows the significant societal economic burdens posed by two chronic inflammatory gastrointestinal diseases; eosinophilic esophagitis (EoE) and microscopic colitis (MC). Both diseases cause long-term inflammation in the digestive system and can lead to additional health problems.

Soran Rabin Bozorg, doctoral student at the Department of Medical Epidemiology and Biostatistics, has studied how these diseases impact society in terms of healthcare costs and work-related productivity in Sweden. He compared people with EoE or MC to others without these diseases and found that patients with EoE incurred 45% higher costs than the general population, while costs for MC patients were 84% higher, largely driven by healthcare utilization and work loss, respectively.

The research highlights the economic strain EoE and MC place on society, with impacts extending beyond healthcare systems to include work productivity losses. The rising incidence of both diseases suggests an escalating economic burden in the absence of effective interventions. Improved treatment strategies targeting disease control could alleviate societal costs, particularly for MC, where work loss accounts for a significant portion of the financial impact.

These findings emphasize the need for improved disease management to reduce the burden of chronic gastrointestinal diseases both to improve individual patient outcomes and reduce societal economic strain.

What are the most important results in your thesis?

"While the awareness of EoE and MC have steadily increased during the last decade, they are still regarded as relatively benign conditions with limited severe complications", says Soran. "However, as a gastroenterologist in training, it has become clear for me that these patients suffer from debilitating symptoms, leading to reduced well-being and impaired quality of life. Reinforcing my clinical experience of EoE and MC, we demonstrate that EoE and MC are also associated with a significant economic burden which is comparable with other gastrointestinal diseases such as inflammatory bowel disease. Furthermore, the measured outcomes are not only associated with economic costs, but also reflect the symptomatic burden that these patients suffer from. Hopefully, these insights can contribute to a better understanding and appreciation of the burden that these diseases impose on patients and society."

What do you think should be done in future research?

"Given the rapidly advancing capabilities of medicine and healthcare, limitation of resources is emerging as the main challenge for improved health and wellbeing. This has led to an increased emphasize on cost-effectiveness in order to effectively allocate resources within the healthcare system and society. To inform such decisions, further health economic studies are imperative", Soran continues. "In relation to EoE and MC, which has been the topic of this thesis, follow-up studies to investigate how recent treatment changes may impact health economic outcomes will be useful to guide future policy and recommendations. However, it is important to stress that while cost reduction may be a possible way to achieve cost-effectiveness, the ultimate goal should always be to alleviate costs by improving the health and wellbeing of patients – and not the other way around."