{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:12:41Z","timestamp":1789517561921,"version":"build-2803163510"},"reference-count":41,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T00:00:00Z","timestamp":1692316800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003514","name":"Kommunfullm\u00e4ktige, Stockholms Stad","doi-asserted-by":"publisher","award":["Dnr 20190638"],"award-info":[{"award-number":["Dnr 20190638"]}],"id":[{"id":"10.13039\/501100003514","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","award":["Dnr 2020\u201002002"],"award-info":[{"award-number":["Dnr 2020\u201002002"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Inflammatory bowel disease has been linked to increasing healthcare costs, but longitudinal data on other societal costs are scarce.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To assess costs, including productivity losses, in patients with prevalent Crohn's disease (CD) or ulcerative colitis (UC) in Sweden between 2007 and 2020.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We linked data from national registers on all patients with CD or\u00a0UC and a matched (sex, birthyear, healthcare region and education) reference population. We assessed mean costs\/year in Euros, inflation\u2010adjusted to 2020, for hospitalisations, out\u2010patient visits, medications, sick leave and disability pension. We defined excess costs as the mean difference between patients and matched comparators.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Between 2007 and 2020, absolute mean annual societal costs in working\u2010age (18\u201364\u2009years) individuals decreased by 17% in CD (\u221224% in the comparators) and by 20% in UC (\u221227% in comparators), due to decreasing costs from sick leave and disability, a consequence of stricter sick leave regulations. Excess costs in 2007 were dominated by productivity losses. In 2020, excess costs were mostly healthcare costs. Absolute and excess costs increased in paediatric and elderly patients. Overall, costs for TNF inhibitors\/targeted therapies increased by 274% in CD and 638% in UC, and the proportion treated increased from 5% to 26% in CD, and from 1% to 10% in UC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Between 2007 and 2020, excess costs shifted from productivity losses to direct healthcare costs; that is, the patients' compensation for sickness absence decreased, while society increased its spending on medications. Medication costs were driven both by expanding use of TNF inhibitors and by high costs for newer targeted therapies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.17675","type":"journal-article","created":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T19:29:36Z","timestamp":1692646176000},"page":"692-703","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Increasing healthcare costs in inflammatory bowel disease 2007\u20132020 in Sweden"],"prefix":"10.1111","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0311-8894","authenticated-orcid":false,"given":"\u00c5sa H.","family":"Everhov","sequence":"first","affiliation":[{"name":"Department of Clinical Science and Education, S\u00f6dersjukhuset Karolinska Institutet  Stockholm Sweden"},{"name":"Clinical Epidemiology Division, Department of Medicine Solna Karolinska Institutet  Stockholm 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