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ESTIMATING THE OUTPATIENT BURDEN OF INFLAMMATORY BOWEL DISEASE (IBD) IN CANADA USING PHYSICIAN BILLING AND PHARMACOECONOMIC SURROGATE MARKERS: A PRELIMINARY ANALYSIS

VK Wong¹, EM Yoshida²
Divisions of Gastroenterology, ¹University of Western Ontario, London, Ontario; ²University of British Columbia, Vancouver, British Columbia

BACKGROUND: Although no specific provincial registries of inflammatory bowel disease exist in Canada, a recent clinical study using physician/hospital billing data suggest that BC has a low incidence and prevalence of IBD. It is our hypothesis that the magnitude of the outpatient burden of IBD in the different regions of Canada may be compared using a pharmacoeconomic surrogate markers such as mesalamine sales and physician office visits .
METHODS: To use data obtained from regional sales of 5 ASA compounds in Canada over the past 72 months as well as ICD9 codes over the past 5 years to estimate the prevalence of Ulcerative Colitis and Crohn's Disease in Canada.
RESULTS: The number of visits made to Canadian office-based physicians for Crohn's disease (CD) or Ulcerative Colitis (UC) between 2001-2005 was obtained from IMS Health Canada via ICD-9 billing codes. Based on Statistics Canada population estimates, there were an average of 6522 office visits per 100,000 people each year in British Columbia, 6473 in the Prairies (Alberta, Saskatchewan, and Manitoba), 6750 in Ontario, 7404 in Quebec, and 5711 in the Maritimes (Newfoundland and Labrador, Nova Scotia, New Brunswick, and Prince Edward Island). The differences between these areas were not statistically significant. Medical therapy for CD and UC was recommended in 47% of visits in BC, 56% in the Prairies, 58% in Ontario, 46% in Quebec, and 44% in the Maritimes. Between September 2004-August 2006, there were 3509 prescriptions filled per 100,000 people for mesalamine, or sulfasalazine products in Alberta, 4223 in Saskatchewan, 3322 in Ontario, 5000 in Quebec, 5290 in New Brunswick, and 4960 in Nova Scotia. Prescription data for BC, Manitoba, Newfoundland and Labrador, and PEI were not available at this time.
CONCLUSION: The surrogate markers of the outpatient IBD burden appear to be approximately evenly distributed across Canada in this preliminary analysis.

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