The cost of caring for patients with inflammatory bowel disease (IBD) continues to increase worldwide. The cause is not only a steady increase in the prevalence of Crohn's disease and ulcerative colitis in both developed and newly industrialised countries, but also the chronic nature of the diseases, the need for long-term, often expensive treatments, the use of more intensive disease monitoring strategies, and the effect of the diseases on economic productivity. This Commission draws together a wide range of expertise to discuss the current costs of IBD care, the drivers of increasing costs, and how to deliver affordable care for IBD in the future. The key conclusions are that (1) increases in health-care costs must be evaluated against improved disease management and reductions in indirect costs, and (2) that overarching systems for data interoperability, registries, and big data approaches must be established for continuous assessment of effectiveness, costs, and the cost-effectiveness of care. International collaborations should be sought out to evaluate novel models of care (eg, value-based health care, including integrated health care, and participatory health-care models), as well as to improve the education and training of clinicians, patients, and policy makers.

Advanced Research Institute Tokyo Medical and Dental University Tokyo Japan

Department of Community Medicine University of Tromsø The Arctic University of Norway Tromsø Norway; Department of Gastroenterology Oslo University Hospital Oslo Norway

Department of Epidemiology and Health Systems Center for Primary Care and Public Health University of Lausanne Lausanne Switzerland

Department of Gastroenterology and Hepatology University Hospital Leuven Leuven Belgium; Faculty of Medicine KU Leuven University Leuven Belgium

Department of Gastroenterology Austin Health Melbourne VIC Australia; Department of Medicine Austin Academic Centre The University of Melbourne Melbourne VIC Australia

Department of Gastroenterology Copenhagen University Hospital North Zealand Hillerød Denmark

Department of Gastroenterology Hepatology and Nutrition University Hospital Zagreb Zagreb Croatia

Department of Gastroenterology Oslo University Hospital Oslo Norway; Institute of Clinical Medicine University of Oslo Oslo Norway

Department of Health Policy and Management School of Public Health Faculty of Health Sciences Ben Gurion University of the Negev Beer Sheva Israel; Guilford Glazer Faculty of Business and Management Ben Gurion University of the Negev Beer Sheva Israel

Department of Internal Medicine Division of Gastroenterology and Hepatology Maastricht University Medical Centre Maastricht Netherlands

Department of Medicine and Community Health Sciences University of Calgary Calgary AB Canada

Department of Medicine and Therapeutics Li Ka Shing Institute of Health Sciences State Key Laboratory of Digestive Disease Institute of Digestive Disease The Chinese University of Hong Kong Hong Kong Special Administrative Region China

Department of Medicine University of Otago Christchurch New Zealand

Department of Preventive Medicine College of Medicine Korea University Seoul South Korea

Department of Surgery Amsterdam University Medical Centers Amsterdam Netherlands

Department of Surgical Oncological and Gastroenterological Sciences University of Padua Padua Italy

Division of Gastroenterology and Hepatology Department of Medicine Mount Sinai Hospital University of Toronto Toronto ON Canada

Division of Gastroenterology and Hepatology Mayo Clinic College of Medicine and Science Rochester MN USA

Division of Gastroenterology Department of Internal Medicine Faculty of Medicine University of Ioannina School of Health Sciences Ioannina Greece

Division of Gastroenterology Department of Internal Medicine Fakeeh University Hospital Dubai United Arab Emirates

Division of Gastroenterology McGill University Montreal QC Canada; Department of Internal Medicine and Oncology Semmelweis University Budapest Hungary

Division of Pediatric Gastroenterology Department of Pediatrics and Center for Gastrointestinal Biology and Disease University of North Carolina at Chapel Hill Chapel Hill NC USA

Faculty of Health Sciences Ben Gurion University of the Negev Beer Sheva Israel

Gastro Unit Medical Division Copenhagen University Hospital Amager and Hvidovre Hvidovre Denmark; Copenhagen Center for Inflammatory Bowel Disease in Children Adolescents and Adults Copenhagen University Hospital Amager and Hvidovre Hvidovre Denmark

Hospital Universitario de La Princesa Instituto de Investigación Sanitaria Princesa Universidad Autónoma de Madrid Madrid Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas Madrid Spain

IBD Clinical and Research Centre for IBD ISCARE Prague Czech Republic; Department of Pharmacology Faculty of Medicine Charles University Prague Czech Republic

IBD Clinical and Research Centre University of Manitoba Winnipeg MB Canada; Department of Internal Medicine Max Rady College of Medicine Rady Faculty of Health Sciences University of Manitoba Winnipeg MB Canada

IBD Service Department of Gastroenterology and Hepatology Royal Adelaide Hospital Adelaide SA Australia; Faculty of Health Sciences University of Adelaide Adelaide SA Australia

IBD Unit St Mark's Hospital Middlesex UK

Institute of Clinical Medicine University of Oslo Oslo Norway

Stanford Health Care Packard Health Alliance Alameda CA USA; Genentech South San Francisco CA USA

Lancet Gastroenterol Hepatol. 2023 May;8(5):396-398. doi: 10.1016/S2468-1253(23)00062-6. PubMed

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