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

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


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

Aim: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Age of Onset
  • Child
  • Child, Preschool
  • Cost of Illness*
  • Crohn Disease / economics*
  • Crohn Disease / epidemiology
  • Crohn Disease / psychology*
  • Crohn Disease / therapy
  • Disease Progression
  • Europe / epidemiology
  • Health Care Costs*
  • Health Expenditures
  • Humans
  • Infant
  • Infant, Newborn
  • Models, Economic
  • Predictive Value of Tests
  • Quality of Life*
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Time Factors
  • Treatment Outcome
  • United States / epidemiology
  • Young Adult

Supplementary concepts

  • Pediatric Crohn's disease