Cost‐of‐Illness of Irritable Bowel Syndrome: A Systematic Review
Klarisse Man Ling Neo, Alicia Le How, Asher Yu Han Ang, Gheng Yong Pang, Shruti Rahul Patil, Hua Wang Tan, Kevin Xiang Zhou, Kewin Tien Ho Siah, Qin Xiang NgABSTRACT
Background and Aim
Given the prevalence and chronicity of irritable bowel syndrome (IBS), this systematic review aimed to synthesize evidence on the cost of illness of IBS, with attention to the relative contributions of direct healthcare and indirect non‐healthcare costs.
Methods
A systematic search of PubMed, Embase, and the Cochrane Library was conducted from inception to August 2025, following PRISMA 2020 guidelines (PROSPERO CRD420251266432). Studies were included if they primarily assessed costs of IBS with sufficiently detailed methodology. Costs were inflation‐adjusted to 2024 US dollars using World Bank consumer price indices and prevailing exchange rates. Risk of bias was assessed using the Consensus on Health Economic Criteria (CHEC) list.
Results
Thirty‐three studies met our inclusion criteria, spanning 14 countries from 1992 to 2022. Mean annual direct healthcare costs per patient ranged widely, from US$193 in Korea to US$31113 in the United States among patients with IBS‐C. Among the 10 studies adopting a societal perspective, indirect costs such as absenteeism, presenteeism, and lost productivity frequently constituted a dominant share of total costs. In some settings, non‐healthcare costs exceeded direct healthcare costs several‐fold (e.g., Sweden: US$17112 vs. US$1943 for IBS‐C). Treatment failure and inadequate symptom control were associated with higher expenditures. IBS‐C incurred the highest subtype‐specific costs, and racial and gender disparities in spending were identified.
Conclusions
IBS imposes a considerable global economic burden. When societal perspectives are adopted, indirect costs emerge as a predominant driver of total costs, necessitating holistic management strategies. Importantly, assessments limited to direct healthcare expenditures underestimate the true economic impact of IBS.