Ali et al.
Int J Pharm Pharm Sci, Vol 9, Issue 1, 44-47
44
PRESCRIPTION PATTERN AND COST OF ILLNESS (COI) OF INFLAMMATORY BOWEL DISEASE
(IBD) IN A TERTIARY CARE HOSPITAL
Original Article
MIRZA MISBA ALI BAIG, SARA FATIMA, MEHRUQ FATIMA, SHAHEDA SIDDIQUI, SYED AMIR ALI, MD NOMAAN ILYAS
Deccan School of Pharmacy, Darussalam, Aghapura, Nampally, Hyderabad 500001
Email: syed.aamir12@gmail.com
Received: 09 Apr 2016 Revised and Accepted: 27 0ct 2016
ABSTRACT
Objective: Treatment of Inflammatory Bowel disease (IBD) centers on agents used to relieve inflammatory process. None of the drugs used for IBD
are curative; at best they serve to control the disease process. The potentially high costs of care associated with inflammatory bowel disease (IBD)
are recognised. The Objective of the present study was to find the Prescription pattern and cost of illness (COI) of IBD in a Tertiary care Hospital.
Methods: 20 IBD patients, in the order they approached the gastroenterology department, were enrolled in the study. Data regarding medication,
hospitalisation, physician office visit, diagnostic costs, travel cost, the cost incurred by caregivers, work and non-work days lost were obtained. The
cost of medications and other healthcare services was determined. The study was approved by the Institutional ethics committee.
Results: The average cost (direct and indirect) per patient for six months was 26,394Rs. Drugs and medical supplies costs (65%) ranked first in the
direct costs category followed by Diagnostic costs (18%), hospitalisation costs (15%) and lastly physician office visit costs (2%). On the other hand,
Cost incurred by caregivers accounted for 45% of the total indirect costs followed by work and nonworking days lost (43%) and finally Travel costs
(2%). Commonly prescribed drugs were corticosteroids and aminosalicylates followed by mucosal protectants, antibiotics and antiemetics. The
most preferred route of drug administration was intravenous followed by oral.
Conclusion: The average COI (direct and indirect) of IBD per patient for six months was 26,394Rs. Drugs and medical supplies accounted for largest
contributions to the overall economic impact of IBD on the Healthcare system. Commonly prescribed drugs were corticosteroids and
aminosalicylates followed by mucosal protectants, antibiotics and antiemetics. This study represents one of the very few studies conducted on COI
of IBD. Large scale studies on economic research are required to further ascertain the impact of Rival therapies and management strategies for IBD.
Keywords: IBD, COI, Prescription Pattern, Pharmacoeconomics
© 2017 The Authors. Published by Innovare Academic Sciences Pvt Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4. 0/)
DOI: http://dx.doi.org/10.22159/ijpps.2017v9i1.14248
INTRODUCTION
Inflammatory Bowel disease (IBD) comprises of Ulcerative Colitis,
Crohn’s Disease and Indeterminate colitis. It is the chronic,
idiopathic, immune mediated, relapsing, inflammatory condition of
the gastrointestinal tract [1, 2]. Standard medical therapy includes
corticosteroid in the acute phase, mesalazine or immuno-
modulators to maintain remission and biological agents for
refractory and/or severe cases [3]. Lack of curative treatment
makes lifelong treatment and Surgery the only options available
for IBD. Ultimately, Hospitalization and surgery contribute to more
than half of the economic burden of IBD to the society [4-7]. The
quality of life of the patient is severely compensated with
continuing symptoms, reduction in the ability to work, social
stigma, bathroom access issues, difficulty with physical intimacy
and restriction in career choices [8].
Initially, IBD was considered to be the disorder of developed
countries, but recent epidemiological data suggest a shift towards
developing nations including Asian countries [9, 10]. The financial
burden of IBD can be divided into direct and indirect costs. Direct
medical costs include expenses for hospitalisations, physician
services, prescription drugs, over-the-counter drugs, skilled
nursing care, diagnostic procedures, and other healthcare services.
Indirect costs are the value of lost earnings or productivity, the
value of leisure time lost, the cost incurred by caregivers and
travel costs [11]. Indian Data on Cost of Illness of IBD is scarce.
Moreover, given the rising prevalence of IBD worldwide, it is
urgently necessary to understand its economic burden and to
provide more robust evaluations of health care interventions
designed to reduce its incidence and impact. Thus the present
study was aimed at finding the cost of illness and prescribing
pattern of IBD.
MATERIALS AND METHODS
Methods
This prospective, observational study was performed on inpatients
and outpatients of Gastroenterology Department of a tertiary care
Hospital in Hyderabad. Due to time constraints, only 20 IBD patients
were included. Patients with confirmed IBD, those willing to give
written or verbal informed consent and above 15 y of age were only
included in the study. Pregnant women and children were excluded
from the study.
Ethical approval
The study was approved by the Institutional Ethics Committee of the
Hospital.
Data collection
This observational, prospective study collected demographic,
clinical, and economic data of IBD patients. The data was collected
from patient’s treatment chart/case sheets, lab reports and from
patient’s attendees. All subjects gave informed consent to participate
in the study and allowed the use of their personal data for research
purposes. Patients were enrolled consecutively, according to the
order in which they presented to the gastroenterologist for
consultation.
Data analysis and statistical methods
Costs are presented to the nearest Indian rupee. Mean patient costs
were taken into consideration for the calculation of total costs.
Descriptive statistics were used to characterise the study
population. Continuous variables were presented as means whereas
categorical variables were presented as numbers and percentages.
International Journal of Pharmacy and Pharmaceutical Sciences
ISSN- 0975-1491 Vol 9, Issue 1, 2017