P1006Health Economics Analysis of IBD at a tertiary centre in India shows larger proportion of non-urban patients and significant discrepancy in affordability of advanced therapies

Abstract Background Inflammatory Bowel Disease (IBD) is a chronic inflammatory condition requiring long-term care, monitoring and use of healthcare resources. The significant increase of disease burden, more recently in newly industrialized nations is a major concern. Assessing health-economics of IBD is critical for resource allocation and policymaking. We aimed to comprehensively evaluate direct annual costs of management that patients bear for both Ulcerative Colitis (UC) and Crohn’s disease (CD), whilst also identifying disparities among patient subgroups. Methods A retrospective review of 135 patients diagnosed with IBD at a tertiary centre in India between Jan 2023 and Aug 2025 was done using EMR. All relevant baseline data was recorded. Patients’ city of residence was classified into Tier 1–3 (1), a widely accepted classification in India (based on population, economic activity, and infrastructure) used for governmental and market research. The approximate mean annual per capita income is estimated to be ₹573,836.14 in Tier-1 cities and ₹440,773.00 in Tier-2/3 cities. (€1 Euro = ₹102.64 INR) The annual cost burden for each patient was categorized into: long term medications, acute flare-ups, supplements, and endoscopy costs. Comparisons of total and component-wise costs across disease and subgroups were performed using independent-sample t-tests for normally distributed variables and the Mann–Whitney U test for non-parametric data. Results Of 135 patients (median age 38y; M = 64.4%), 72 had UC and 63 had CD. There were more patients from Tier-2/3 cities compared to Tier-1. The median (IQR) annual cost burden per patient was ₹29,351 (18,544- 495,816). Medication expenses accounted for 68% of total, while acute flare-up, supplements p = 0.014]. Although baseline characteristics were comparable between the two groups, a larger proportion of Tier-1 group were on biologics (40.7% vs. 21%, p = 0.013), leading to a significant difference in total costs. IBD-related expenses accounted for 51.9% of the mean annual per capita income in Tier-1 cities, compared with 36.4% in Tier-2/3 areas (Table 2). Conclusion A larger proportion of IBD patients at our centre were from Tier-2/3 cities, indicating that IBD is no longer limited to the urban population. The economic burden of treatment is considerable, with medications comprising the largest share of total costs. Patients from Tier-1 cities had a higher overall cost burden, likely due to better affordability reflected in greater use of biologics. Reference: 1. Government of India, Ministry of Finance, Department of Expenditure. (2008). Recommendations of the Sixth Central Pay Commission: Decision of Government relating to grant of allowances (Office Memorandum). https://dispur.nic.in/sixthpay/sixth-pay-allowances.pdf Conflict of interest: Ashok S, Shalini: none Chamarthi, Govind Datta: No conflict of interest Kalachannegowda, Nandish Hullenahalli: No conflict of interest Reddyvari, Kiran: No conflict of interest Gopalakrishnan, Gayathri: No conflict of interest Kumar N, Sunil: No conflict of interest Kumar B. R, Vinay: No conflict of interest Shankar, Sahana: No conflict of interest Rao, Aditi: No conflict of interest Paul, Anju: No conflict of interest