Direct costs for nonsurgical management of Chronic Pancreatitis in a tertiary care teaching hospital

Nagesh Kamat, Ganesh Pai, Surulivel Rajan Mallayasamy, Asha Kamath, Rajasulochana S

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Abstract

Background: Chronic pancreatitis (CP) is a leading cause of hospitalization among gastrointestinal diseases resulting in considerable financial burden to patients. However the direct costs for nonsurgical management in CP remains unexplored. Methods: A cross sectional study was carried out (2011–14) in the Department of Gastroenterology, Kasturba Hospital, Manipal, India. Demographic and clinical data on laboratory investigations, interventions and follow up were obtained from the medical records department. Item costs were derived from the hospital electronic billing section. Cost was expressed as median annual cost per patient. Results: 65 (male 48; 73.8%) patients were included. Their median age was 31 (range 12–68) years. The annual median (IQR) total cost per patient was INR 88,892 (70,550.5–116,004); [USD 1410(1119–1841); € 1155(916–1507)], comprising of INR 61,089 (39,102.5–90,360.5) [USD 970 (621–1434); € 793(508–1174)] for outpatient management and INR 32,450 (11,016–46,958) [USD 515 (175–745); €421(143–610)] for hospitalization. 69.5% of the treatment cost was attributed to outpatient treatment. Drugs contributed to 54%, hospitalization incurred 30.5%, investigations 12% and professional fees (3.5%) of the total cost. Pancreatic enzyme replacement therapy (PERT) cost contributed to three-quarters of drug therapy. Use of rabeprazole as against pantoprazole reduced the overall annual cost of therapy by 4%. Conclusions: This study depicts the first nonsurgical management of accrued direct costs associated with CP due to expensive medications. Due to the high cost for PERT, its usefulness needs proper validation by cost benefit analysis.

Original languageEnglish
Pages (from-to)1-6
Number of pages6
JournalExpert Review of Pharmacoeconomics and Outcomes Research
DOIs
Publication statusPublished - 13-10-2018

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Chronic Pancreatitis
Tertiary Healthcare
Teaching Hospitals
Costs and Cost Analysis
International Normalized Ratio
Enzyme Replacement Therapy
Hospitalization
Outpatients
Hospital Medical Records Department
Rabeprazole
Fees and Charges
Gastrointestinal Diseases
Gastroenterology
Health Care Costs
Cost-Benefit Analysis
India
Cross-Sectional Studies
Demography
Drug Therapy

All Science Journal Classification (ASJC) codes

  • Health Policy
  • Pharmacology (medical)

Cite this

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title = "Direct costs for nonsurgical management of Chronic Pancreatitis in a tertiary care teaching hospital",
abstract = "Background: Chronic pancreatitis (CP) is a leading cause of hospitalization among gastrointestinal diseases resulting in considerable financial burden to patients. However the direct costs for nonsurgical management in CP remains unexplored. Methods: A cross sectional study was carried out (2011–14) in the Department of Gastroenterology, Kasturba Hospital, Manipal, India. Demographic and clinical data on laboratory investigations, interventions and follow up were obtained from the medical records department. Item costs were derived from the hospital electronic billing section. Cost was expressed as median annual cost per patient. Results: 65 (male 48; 73.8{\%}) patients were included. Their median age was 31 (range 12–68) years. The annual median (IQR) total cost per patient was INR 88,892 (70,550.5–116,004); [USD 1410(1119–1841); € 1155(916–1507)], comprising of INR 61,089 (39,102.5–90,360.5) [USD 970 (621–1434); € 793(508–1174)] for outpatient management and INR 32,450 (11,016–46,958) [USD 515 (175–745); €421(143–610)] for hospitalization. 69.5{\%} of the treatment cost was attributed to outpatient treatment. Drugs contributed to 54{\%}, hospitalization incurred 30.5{\%}, investigations 12{\%} and professional fees (3.5{\%}) of the total cost. Pancreatic enzyme replacement therapy (PERT) cost contributed to three-quarters of drug therapy. Use of rabeprazole as against pantoprazole reduced the overall annual cost of therapy by 4{\%}. Conclusions: This study depicts the first nonsurgical management of accrued direct costs associated with CP due to expensive medications. Due to the high cost for PERT, its usefulness needs proper validation by cost benefit analysis.",
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