Background: Crohn’s disease (CD) and ulcerative colitis (UC) are costly conditions that require life-long disease management. Both conditions can first present at any age, but it is unknown how healthcare costs differ according to the age at first diagnosis. Methods: Healthcare costs were evaluated for patients with CD or UC using data on medical services (inpatient and outpatient) and outpatient pharmacy spending from the Truven MarketScan health insurance claims (January 2008‒September 2015). Variations in cost over a lifetime were captured in cost-state Markov models based on diagnosis age. For comparison, CD and UC patients were propensity score matched (1:1) to controls without CD or UC based on other demographics and health. Incremental cost, defined as the difference in costs between CD/UC patients and controls, was compared for the first year after diagnosis with the average annual cost over the entire post-diagnosis life. Results: A total of 78,620 CD and 85,755 UC patients and their respective 78,620 and 85,755 matched controls were included in this analysis. For CD patients, the average annual incremental cost (AAIC) was $22,856 for those diagnosed at ages 0 to 11 compared with $46,610 for the first year after diagnosis (Table). Both the average annual cost and the cost in the first year after diagnosis declined with diagnosis age. AAIC decreased to $14,276 for individuals diagnosed at age 70+ years and to $14,049 for their first year after diagnosis. For UC patients, AAIC was $11,032 for those diagnosed at ages 0 to 11 ($29,996 in the first year after diagnosis). AAIC decreased to $7,224 for individuals aged 70+ years and to $10,473 for their first year after diagnosis. Conclusion: Young patients incur the highest cost for CD and UC in the first year after diagnosis and over the course of their lives. This study highlights the need for additional efforts to better control CD and UC, particularly in pediatric and young adult patients.
