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EXECUTIVE SUMMARY


EXECUTIVE SUMMARY


Inflammatory bowel disease (IBD) is a group of disorders that causes sections of the gastrointestinal tract to become severely inflamed and ulcerated. An abnormal response of the body’s immune system plays a role in each of the two main forms of IBD; namely Crohn’s disease (CD) and ulcerative colitis (UC). In the absence of a cure, current therapies are directed at achieving and maintaining freedom from symptoms. Most people require ongoing medication; when this fails, surgery is often required. These are lifelong diseases, usually starting in early adulthood in otherwise healthy, active individuals. CD and UC also occur in children and IBD is increasingly being diagnosed in young children. IBD severely impacts quality of life through ongoing debilitating symptoms, reduction in ability to work, social stigma, management of bathroom access issues, difficulty with physical intimacy, and restriction in career choices.


People with IBD in Canada There are approximately 233,000 Canadians living with IBD: 129,000 with CD and 104,000 with UC. Over 10,200 new cases are diagnosed every year – 5,700 with CD and 4,500 with UC. Canada has among the highest reported prevalence (number of people with CD or UC) and incidence rates (number of new cases per year) of IBD in the world. The prevalence of IBD currently in Canada is nearly 0.7%, equating to more than 1 in every 150 Canadians. IBD can be diagnosed at any age, but has a typical age of onset in the twenties. Incidence of IBD has been rising, particularly since 2001, and significantly so in children under the age of 10 years. An estimated 5,900 Canadian children have IBD. People with IBD have an elevated risk of developing colorectal cancer. People with CD face a significantly elevated risk of premature death (47% higher) than the general public. IBD is more than twice as common as multiple sclerosis or Parkinson’s disease; about as common as Type I diabetes or epilepsy; and somewhat less common than other chronic diseases such as schizophrenia or rheumatoid arthritis. Compared to the general population, quality of life in IBD is low across all dimensions of health.


Economic Costs of IBD Economic costs for IBD are conservatively estimated at $2.8 billion in Canada in 2012 (over $11,900 per person with IBD every year). Direct medical costs totalled over $1.2 billion and are dominated by medications ($521 million), followed by hospitalizations ($395 million), and physician visits ($132 million). Costs are higher for CD than for UC, due to more frequent hospitalizations and greater use of newer, expensive drugs. Indirect costs (to society and to the patient, including loss of productivity) are greater than direct medical costs: over $1.6 billion in 2012. Indirect costs are dominated by lower labour participation rates (long-term work losses of $979 million), followed by patient out-of-pocket expenses ($300 million) and then short-term work absences ($181 million). Indirect costs are similar between CD and UC.


Areas of Greatest Challenge In addition to the tremendous impact that IBD has on quality of life, people living with IBD often face many other challenges in the current environment. These include lack of awareness of IBD as a chronic disease, late or inappropriate diagnosis, inequitable access to health care services and expensive medications, diminished employment prospects and limited community-based supports.


THE IMPACT OF INFLAMMATORY BOWEL DISEASE IN CANADA 7


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