Crohn's disease[1] is one in a group of chronic conditions referred to as inflammatory bowel disease, which are characterized by inflammation of all or part of the digestive tract. In Crohn's disease, the part of the digestive tract typically affected is the end portion of the small intestine, called the ileum. Crohn's disease can be debilitating, and may lead to life-threatening complications. The exact cause[2] of the condition is unknown.
Typical costs:
Patients seeking medical care for Crohn's disease would start with an office visit to a primary care physician, which is typically covered by health insurance. For patients covered by health insurance, out-of-pocket costs typically consist of a copay of $10-$50 or more, or coinsurance of 10%-50% or more. For patients without health insurance, an office visit typically costs $50-$200 or more.
Drug therapy is typically the first course of action. For moderate to severe cases of Crohn's, a doctor may prescribe one or more kinds of drugs to curb inflammation and manage symptoms, including aminosalicylates[3] , corticosteroids[4] , or immune system suppressors[5] . These medications can cost $20-$900 or more, depending on the type and dose of drug needed, and whether the medicine is available in generic form.
According to WebMD[6] many patients are first treated with the anti-inflammatory drug sulfasalazine[7] , which typically costs about $21. The immune system suppressor Infliximab (Remicade), which may be recommended if other drugs fail, costs about $900 for a 100 mg dose.
If drug therapy and lifestyle changes[8] fail, a surgical procedure called a bowel resection may be performed. At Saint Elizabeth Regional Medical Center [9] in Lincoln, NE, major bowel procedures like this typically cost $30,000 or more. According to a study[10] that examined costs related to IBD conditions, the average total cost of hospitalization is $35,378.
Over-the-counter medications[11] may help to alleviate mild pain or other symptoms[12] , such as diarrhea or constipation, and typically cost $4-$25, depending on the quantity and whether the patient buys a name brand or its generic equivalent. For example, six tablets of the anti-diarrheal Loperamide (Imodium)[13] costs about $5, while 44.2 oz of the fiber supplement psyllium powder (Metamucil)[14] , costs $15. Insurers do not typically pay for nonprescription medicines.
After an initial evaluation, a primary doctor will likely refer patients exhibiting symptoms[15] to a gastroenterologist for more detailed testing to rule out other possible conditions. This may include diagnostic exams[16] such as blood tests, a colonoscopy or an X-ray of the abdominal area.
The goal of treatment[17] is to reduce inflammation, and drug therapy is typically the first course of action. If lifestyle changes[18] , drug therapy, or other treatments don't relieve symptoms, a bowel resection may be recommended. During surgery, the damaged portion of the digestive tract is removed and the healthy sections are reconnected.
According to the Mayo Clinic[19] , as many as three out of four people with Crohn's disease will eventually need some type of surgery. Moreover, since Crohn's typically recurs elsewhere in the digestive tract, the benefits of surgery are usually temporary, and many patients will later need a second procedure or more.
Additional costs:
Since IBD patients often have reduced bone density, either from decreased calcium absorption or as the result of using certain medications, a doctor may recommend taking a calcium supplement[20] . Calcium supplements typically cost $4-$25. For example, 150 tablets of Caltrate[21] costs $14 for 150 tablets.
Because stress can aggravate symptoms, therapies that help patients manage negative emotions or reduce anxiety such as massage may help to prevent IBD conditions from worsening.
Discounts:
Outlets such as Costco[22] and Walmart[23] often sell prescription and over-the-counter drugs at significant savings. Walmart, for example, has a prescription drug program[24] that includes certain generic drugs at commonly prescribed dosages.
Many hospitals offer discounts of 30% of more to uninsured or cash-paying patients. At St. Joseph Hospital[25] in Orange, CA, for example, patients without health insurance may qualify for a 45% discount off billed charges. They'll also be offered an additional 10% discount if payment is made within 10 days of receiving a bill.
Shopping for crohn's disease treatment:
The American College of Gastroenterology offers a physician locator[26] .
The Mayo Clinic offers a list of tips[27] to help IBD patients prepare for their next doctor's appointment.
Patients who do not respond to conventional drugs recommended for IBD may consider enrolling in a clinical trial[28] .
Material on this page is for informational purposes only and should not be construed as medical advice. Always consult your physician or pharmacist regarding medications or medical procedures.
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