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The aim of the study is to estimate the disability insurance costs (social security system in Italy is financed by public expenditure) induced by patients with Inflammatory Bowel Disease (IBD) and specifically for Crohn's disease (CD) and Ulcerative Colitis (UC) between 2009 and 2015.
Methods
We analyzed the database about the disability insurance awards and the mean cost per benefit of the National Institute of Social Security (INPS) for two types of social security benefits: incapacity pensions (IP - for people without workability) and disability benefits (DB - for people with reduced work ability). From this data, we have estimated the total benefit provided and the total costs for each disease. A probabilistic model with a Monte Carlo simulation was developed in order to estimate the total benefits provided and costs.
Results
For CD, an average of 820 beneficiaries of social security benefits were detected per year (2009-2015): the total expenditure was EUR 50 million, EUR 7 million per year (about EUR 7,900 per patient); for UC, about 1,550 beneficiaries per year were detected and the total expenditure was EUR 93 million, EUR 13 million per year (about EUR 8,600 per patient).
Conclusions
The disability insurance costs related with the management of CD and UC showed a significant impact on the expenditure for the Italian system: the most important costs for disability for CD and UC in Italy in the analyzed period were DB (92 percent for CD and 95 percent for UC). Rapid access to innovative treatments could reduce the costs incurred by the social security system.
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