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Gastrointestinal Diseases in America: The Costly Impact on Employers and Patients

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By SAM HOLLIDAY

Medically reviewed by Jenny Blair, MD

Gastrointestinal diseases like inflammatory bowel disease (IBD), gastroesophageal reflux disease (GERD), and irritable bowel syndrome (IBS) are more prevalent—and costlier—than many employers realize. Up to 70 million Americans are affected by gastrointestinal (GI) diseases each year—twice as many people as those living with diabetes (34.2 million).[1],[2] Overall direct healthcare costs for GI diseases are estimated to be $136 billion each year in the U.S., more than heart disease ($113bn) and mental health disorders ($99bn) [Figure 1][3]. However, GI conditions are often overlooked by employers as they consider their benefit offerings, even though a large proportion of their workforce is likely living and struggling with these conditions.

The Rising Direct Cost of GI Conditions

Irritable bowel syndrome, characterized by symptoms like recurring abdominal pain, constipation and diarrhea, affects as many as 15% of people worldwide[4]—though only 5 to 7% of people receive a diagnosis.[5] While this low diagnosis rate limits the value of cost estimates, the direct medical costs of IBS, excluding prescriptions and over-the-counter medicines, have been estimated to be $10 billion (or nearly $14 billion in today’s dollars) in the US.[6] Medication spend is another cost driver as IBS patients receive an average of 3 to 7 medications annually.[7] That’s 2 to 3 more prescriptions than a person without IBS would receive over a year.

Another important financial consideration for IBS is out-of-pocket (OOP) spend incurred by patients on over-the-counter medications, probiotics and functional medicine providers. One survey of about 600 people with IBS found that patients spent an average of $288 (2020 equivalent: $693) during a three-month period on over-the-counter and alternative therapies for IBS symptoms.[8] A 2007 study published in the journal Alimentary Pharmacology and Therapeutics looked at the OOP spend among people with IBS and found that individuals incurred an annual average of $406 OOP costs for the treatment of IBS symptoms.[9]

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