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Dig Dis Sci. 2015 Feb;60(2):299-312. doi: 10.1007/s10620-014-3368-z. Epub 2014 Sep 26.

The economic and quality-of-life burden of Crohn's disease in Europe and the United States, 2000 to 2013: a systematic review.

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PHMR Associates, London, UK.



Crohn's disease (CD) is associated with a substantial healthcare burden that affects the patient, healthcare systems and society in general.


To provide a systematic evaluation of published data relating to the economic and health-related quality-of-life (HRQoL) burden of CD in selected European countries (Germany, France, UK, Italy, Spain) and the USA since 2000.


We undertook a systematic review of publications relating to CD, its economic burden and impact on HRQoL. Research questions focused on the disease costs from a societal perspective and HRQoL burden in adults and pediatric/adolescent patients according to disease stage/severity. Total, direct and indirect costs were identified, as well as the impact of CD on HRQoL measured using both generic and disease-specific instruments.


Overall, 61 publications met the research criteria (38 on costs, 23 on HRQoL). CD in the USA and Europe together was associated with annual total costs of nearly <euro>30 billion, more than half due to indirect costs. HRQoL was consistently and statistically significantly lower among CD patients compared with normal populations, due to physical, emotional and social effects.


CD is a global health problem with high societal costs and substantial HRQoL burden. High-value care pathways including cost-effective therapies will help to induce and maintain remission, reduce complications of disease and improve HRQoL.

[Indexed for MEDLINE]

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