Gastroenterology

Gastroenterology

Volume 122, Issue 5, May 2002, Pages 1500-1511
Gastroenterology

Special Reports and Reviews
The burden of selected digestive diseases in the United States,☆☆

https://doi.org/10.1053/gast.2002.32978Get rights and content

Abstract

Background & Aims: Gastrointestinal (GI) and liver diseases inflict a heavy economic burden. Although the burden is considerable, current and accessible information on the prevalence, morbidity, and cost is sparse. This study was undertaken to estimate the economic burden of GI and liver disease in the United States for use by policy makers, health care providers, and the public. Methods: Data were extracted from a number of publicly available and proprietary national databases to determine the prevalence, direct costs, and indirect costs for 17 selected GI and liver diseases. Indirect cost calculations were purposefully very conservative. These costs were compared with National Institutes of Health (NIH) research expenditures for selected GI and liver diseases. Results: The most prevalent diseases were non–food-borne gastroenteritis (135 million cases/year), food-borne illness (76 million), gastroesophageal reflux disease (GERD; 19 million), and irritable bowel syndrome (IBS; 15 million). The disease with the highest annual direct costs in the United States was GERD ($9.3 billion), followed by gallbladder disease ($5.8 billion), colorectal cancer ($4.8 billion), and peptic ulcer disease ($3.1 billion). The estimated direct costs for these 17 diseases in 1998 dollars were $36.0 billion, with estimated indirect costs of $22.8 billion. The estimated direct costs for all digestive diseases were $85.5 billion. Total NIH research expenditures were $676 million in 2000. Conclusions: GI and liver diseases exact heavy economic and social costs in the United States. Understanding the prevalence and costs of these diseases is important to help set priorities to reduce the burden of illness.

GASTROENTEROLOGY 2002;122:1500-1511

Section snippets

Materials and methods

The goal of this study was to find information on the prevalence and cost of selected digestive and liver diseases. A select, rather than inclusive, set of GI and liver diseases was chosen owing to financial and time constraints. The diseases included in the report were selected based on the input of experts in gastroenterology and epidemiology, on the perceived high prevalence of the condition, on the availability of data, and the perceived research needs. As a result, we excluded some

Results

The prevalence, direct costs, and indirect costs for the 17 GI diseases selected for this report are summarized in Table 3.The total direct and indirect costs in 1998 dollars of those diseases ranged from $9.8 billion (GERD) to $0.37 billion (Barrett's esophagus). Based on 1998 data, the most prevalent of these diseases is: non–food-borne gastroenteritis and other GI infections (135 million cases), food-borne illness (76 million), gallbladder disease (20.5 million), GERD (18.6 million), and IBS

Discussion

The present report estimates that a group of 17 GI and liver disorders was responsible for $36.0 billion in direct costs and, based on a very conservative determination, $2.8 billion in indirect costs in 1998. Adjusting for inflation, this represents approximately $43 billion in the year 2000. GERD was the most costly disease in 2000 with total costs of $10 billion, followed by gallbladder disease ($6.5 billion), and colorectal cancer ($5.3 billion). The most prevalent disorders were

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Address requests for reprints to: Robert S. Sandler, M.D., M.P.H., CB# 7080, 719 Burnett-Womack Building, University of North Carolina, Chapel Hill, North Carolina 27599-7080. e-mail [email protected]; fax (919) 966-2478.

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Supported by an unrestricted grant from TAP Pharmaceutical Products, Inc. to the American Gastroenterological Association.

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