• Foram Mehta.
• MehtaF@aetna.com.
• Am J Manag Care. 2016 Mar 1; 22 (3 Suppl): s51-60.

AbstractCrohn's disease and ulcerative colitis, the 2 most common inflammatory bowel diseases (IBDs), are chronic conditions with periods of exacerbation and remission. Patients with IBD experience clinical gastrointestinal (GI) symptoms, as well as the emotional burden that accompanies chronic conditions characterized by reduced quality of life and ability to work. With estimates of direct and indirect costs ranging between $14.6 and $31.6 billion in 2014, there is a significant healthcare burden associated with IBD. Although treatment expenses make up a significant portion of the cost of IBD, studies show that inappropriate treatment, lack of adherence to therapeutic regimens, or suboptimal treatment increase the cost burden. Costs for IBD include hospitalizations, the eventual need for surgery due to disease complications, and physician visits. The staggering economic burden of IBD makes early diagnosis, coupled with effective treatment at onset, imperative. Therefore, management of IBD must evolve beyond symptom control and toward sustained control of GI inflammation as measured by endoscopic, radiologic, and laboratory parameters.Treatment advances have made deep remission a realistic target for some people with IBD. However, achieving deep remission requires a shift in the management paradigm of IBD, encouraging individualized treatment with biologics that focuses less on treating symptoms and more on preventing potential disease progression. Although expensive at onset, this management strategy may ultimately lead to decreased rates of surgeries and hospitalizations, potentially yielding lower long-term costs for treatment.

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