Characterising the Economic Burden of Functional Dyspepsia: A Cost‐of‐Illness Study of Direct and Indirect Costs

BACKGROUND: Functional dyspepsia (FD) is a prevalent disorder of gut-brain interaction (DGBI) and is associated with substantial impact on health care utilisation. However, analyses examining patient-specific characteristics that contribute to this burden remain limited. This study assessed the economic burden of patients with FD and examined patient-specific characteristics related to costs. METHODS: Patients who had been recruited for a randomised controlled trial completed several questionnaires. Health care utilisation and productivity losses were measured using the iMTA Medical Consumption Questionnaire and Productivity Cost Questionnaire. Participants also completed the EuroQol 5-Dimension 5-Level, Nepean Dyspepsia Index, Generalised Anxiety Disorder-7, and Patient Health Questionnaire-9. Non-parametric bootstrapping was applied to calculate the mean annual costs. Multivariable linear regression was used to identify patient-specific characteristics associated with costs. RESULTS: Data were obtained from 73 participants (median age 39 years; 75% female). Mean annual total costs accounted for €12,192 (2.5th to 97.5th percentiles, €1125 to €36,369), of which €10,240 (2.5th to 97.5th percentiles, €0 to €34,771) were indirect costs. Higher disease-specific quality of life (QoL) was associated with lower annual total costs (regression slope = -€4726 per 0.1-point increase in QoL; 95% CI, -€7636 to -€1815; p = 0.002), while symptom severity, generic health-related QoL or scores for anxiety or depression were not significantly associated. CONCLUSION: Patients with poorer disease-specific QoL, but not necessarily those with more severe symptoms or higher scores for anxiety and depression, are particularly likely to incur higher annual costs. Understanding the nature of costs and associated patient characteristics is essential for enabling more targeted strategies. TRIAL REGISTRATION: The TENDER trial was registered on Clinicaltrials.gov under NCT03652571 on August 17, 2018.