A Cost-Effectiveness Comparison of Alosetron, Eluxadoline, and Rifaximin in the Treatment of Irritable Bowel Syndrome with Diarrhea

Irritable Bowel Syndrome (IBS) was first defined in 1978, and is characterized by abnormal pain, bloating, discomfort and disturbed bowel habits. IBS is a chronic and relapsing gastrointestinal disorder with global prevalence of 5-20% [1-3]. This disorder consists of four subtypes: IBS with constipation (IBS-C), IBS with diarrhea (IBS-D), mixed bowel pattern (IBS-M), and unclassified IBS [1,2]. Options for IBS treatment include changes of diet, antispasmodics, exercise, laxatives, antidiarrheals, antidepressants and serotonin agents [4]. Although a variety of pharmacological agents have been provided to manage IBS symptoms, there are still no conclusive treatment strategies for this disorder. Due to the frequency of symptoms and lack of curative agents for IBS, the disease imposes huge economic and health burden on the patient. As per a recent report published on May 2016 by International foundation for gastrointestinal disorder, in US alone there are between 2.4-3.5 million annual physician visits with estimated direct and indirect costs of $21 billion or more [5]. Chronic and recurrent IBS costs the patient both financially and from the humanistic perspectives: cost of prescription medications, over-the-counter treatments, emergency-room visits, and hospitalizations; and cost of lost productivity, and decreased quality of life (QoL). A systematic review regarding the annual economic burden of IBS in the United States, attributed 1.35 billion dollars and 200 million dollars to direct and in direct costs associated with IBS, respectively [6]. Furthermore, on average, patients with severe refractory IBS symptom suffer for24 days per month with abdominal pain, and for 145 days in a year their activities were restricted by these symptoms [7]. Considering IBS symptoms consumes a huge amount of money in medications, incurs large effect on the productivity of the patient, Volume 4 Issue 6 2016