Treating IBS is no small task. There is significant cost both to the individuals who live with the condition and to the overall healthcare system
Average Cost of IBS Treatment to Individuals
Although rigorous trials have shown that most of the newer evidence-based therapies improve both abdominal symptoms and bowel problems, these agents are prohibitively expensive for patients with limited insurance coverage. "Some of the newer FDA-approved therapies can cost an individual $800 to $1,200 out-of-pocket, and with rare exceptions, these are not affordable," said Brenner. "Thus, patients can't achieve their symptomatic goals, and physicians are limited in what they can truly offer. And without improvements in symptoms, the direct and indirect costs of this disorder are likely to continue to rise."
While the quality-of-life impact of IBS is gaining recognition, gastroenterologists hope greater awareness of the syndrome's true economic burden will help streamline diagnosis, expand first-line treatment with proven agents, and ultimately reduce overall costs.
In one industry-led case-control study published in 2016 of 19,653 commercially insured IBS-D patients and 19,653 matched controls, Jessica Buono and colleagues found that IBS-D patients had a significantly higher mean annual number of hospitalizations, emergency and office visits, and 30-day prescription fills.
Mean annual all-cause healthcare costs for IBS-D patients were $13,038, with 58.4% attributable to office visits and other outpatient services and tests. About 20% of the costs were attributable to prescriptions, inpatient admissions (13.6%), and emergency department visits (8.5%). Adjusted incremental annual all-cause costs associated with IBS-D were $2,268: $9,436 for IBS-D patients versus $7,169 for matched controls per patient per year. Of these, 78% were due to medical costs and 22% to prescription fillings.
A case-control study by Jalpa Doshi et al in 2014 of 7,652 of commercially insured IBS-C patients and controls found that the mean annual all-cause healthcare costs for IBS-C patients were $11,182 – more than half for physician and outpatients visits. Adjusted incremental annual all-cause healthcare costs were $3,856: $8,621 for IBS-C patients versus $4,765 for controls per patient per year. Of these costs, 78.1% were due to medical services and 21.9% to prescriptions.
Overall Cost to the Healthcare System
Irritable bowel syndrome (IBS) affects at least 35 million Americans, and inadequately controlled, can sabotage patients' quality of life and earning power, curtailing workplace and educational productiveness.
Patients with IBS tend to use a wide range of medications for relief of symptoms. Diagnosing and managing IBS can be difficult due to the lack of a diagnostic marker and effective treatment options.
The primary components of indirect cost for patients with IBS are missed work, decreased work productivity, and diminished health-related quality of life. Estimates have placed IBS as the second leading cause of absenteeism -- ill health has been recorded for an average of 6.4 days in patients with IBS compared with 3.0 days in matched controls of patients without IBS. In terms of the impact on patients' lives, quality of life has been low and is similar to that for patients with other chronic conditions such as chronic depression. Unfortunately, most patients with IBS are not formally diagnosed, or are diagnosed much later than their initial presentation of symptoms.
In summary, IBS imposes a significant socioeconomic burden. Development of evidence-based guidelines aim to help promote early diagnosis of IBS and may result in decreasing some of the economic burden. Educational awareness programs have been shown to reduce costs associated with other long-term disorders, and the implementation of programs on patients for IBS may have similar results.