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TIME-trend and forecasting of the economic impact of inflammatory bowel disease in Catalonia: a population-based analysis

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Few studies have assessed the distribution and temporal trends of healthcare expenditures related to inflammatory bowel disease (IBD). The aims of the study were to analyze the expenditure trends for IBD patients in Catalonia from 2011 to 2024, to identify key cost drivers, and to forecast future costs through 2036. All patients with a diagnosis of IBD included in the Catalan Health Surveillance System (CHSS) were eligible. CHSS compiles prospective data from public healthcare coverage of 8 million people in 2024. Healthcare utilization was analyzed, and expenditures were calculated using standard costs defined by the Catalan Department of Health. All expenditures were adjusted to 2024 euros using the Consumer Price Index to enable comparisons across years. Costs were estimated for IBD overall, Crohn’s disease (CD) and ulcerative colitis (UC). An autoregressive integrated moving average model was used to forecast total costs up to 2036. IBD-related healthcare expenditure tripled from €67.4 M in 2011 to €201.6 M in 2024, while per-patient costs rose from €3,981 to €4,753. Biologic therapies were the main cost driver, especially in CD. Mean per-patient biologic costs decreased by 16.6% in CD but increased by 44.5% in UC. CD patients consistently incurred higher per capita costs. Forecasts indicate continued growth in total expenditure, reaching €319.0 M by 2036. Overall, IBD-related healthcare expenditures in Catalonia markedly increased from 2011 to 2024, driven mainly by the increase in IBD prevalence. Per-patient cost moderately increased. Per-patient cost containment was observed in pharmaceutical costs, probably due to a strict policy favoring the use of biosimilars. These findings may be of help for designing future healthcare policies.

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