RT Journal Article
SR Electronic
T1 The costs of functional gastrointestinal disorders and related signs and symptoms in infants: a systematic literature review and cost calculation for England
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e015594
DO 10.1136/bmjopen-2016-015594
VO 7
IS 11
A1 Mahon, James
A1 Lifschitz, Carlos
A1 Ludwig, Thomas
A1 Thapar, Nikhil
A1 Glanville, Julie
A1 Miqdady, Mohamad
A1 Saps, Miguel
A1 Quak, Seng Hock
A1 Lenoir Wijnkoop, Irene
A1 Edwards, Mary
A1 Wood, Hannah
A1 Szajewska, Hania
YR 2017
UL http://bmjopen.bmj.com/content/7/11/e015594.abstract
AB Objectives To estimate the cost of functional gastrointestinal disorders (FGIDs) and related signs and symptoms in infants to the third party payer and to parents.Study design To estimate the cost of illness (COI) of infant FGIDs, a two-stage process was applied: a systematic literature review and a COI calculation. As no pertinent papers were found in the systematic literature review, a ‘de novo’ analysis was performed. For the latter, the potential costs for the third party payer (the National Health Service (NHS) in England) and for parents/carers for the treatment of FGIDs in infants were calculated, by using publicly available data. In constructing the calculation, estimates and assumptions (where necessary) were chosen to provide a lower bound (minimum) of the potential overall cost. In doing so, the interpretation of the calculation is that the true COI can be no lower than that estimated.Results Our calculation estimated that the total costs of treating FGIDs in infants in England were at least £72.3 million per year in 2014/2015 of which £49.1 million was NHS expenditure on prescriptions, community care and hospital treatment. Parents incurred £23.2 million in costs through purchase of over the counter remedies.Conclusions The total cost presented here is likely to be a significant underestimate as only lower bound estimates were used where applicable, and for example, costs of alternative therapies, inpatient treatments or diagnostic tests, and time off work by parents could not be adequately estimated and were omitted from the calculation. The number and kind of prescribed products and products sold over the counter to treat FGIDs suggest that there are gaps between treatment guidelines, which emphasise parental reassurance and nutritional advice, and their implementation.