NCDD Meeting 11-19-07Outline

• Table of Contents

• Chapter Examples– GI infections– Colorectal cancer

• Cost of Digestive Diseases

• National Endoscopy Data

Contents

Chapter 1: Introduction

Chapter 2: Intestinal Infections

Chapter 3: Viral HepatitisChapter 4: Esophageal CancerChapter 5: Gastric Cancer

Chapter 6: Cancer Of The Small Intestine

Chapter 7: Colorectal Cancer

Chapter 8: Liver CancerChapter 9: Bile Duct CancerChapter 10: Gallbladder CancerChapter 11: Pancreatic CancerChapter 12: Any Digestive Cancers

Contents (continued)

Chapter 13: Hemorrhoids

Chapter 14: Gastroesophageal Reflux Disease

Chapter 15: Peptic Ulcer Disease

Chapter 16: Functional Disorders

Chapter 17: Appendicitis

Chapter 18: Abdominal Wall Hernia

Chapter 19: Inflammatory Bowel Disease

Chapter 20: Diverticular Disease Of The Intestine

Chapter 21: Acute And Chronic Liver Disease

Chapter 22: Gallstones

Chapter 23: Acute And Chronic Pancreatitis

Chapter 24: Celiac Disease

Contents (continued)

Chapter 25: Any Digestive Diseases

Chapter 26: Endoscopy (National Endoscopy Database)

Chapter 27: Cost Of Digestive Diseases

Chapter 28: Conclusion

Appendix 1: Summary Of Surveys Used In The Burden Report

Appendix 2: ICD-9-CM, ICD-9, AND ICD-10 DIGESTIVE DISEASE CODES

Ambulatory Care Visits and Hospital Discharges with First-Listed and Any-Listed Diagnoses of Intestinal Infections by Age, Race, and Sex

in the United States, 2004

Deaths and Years of Potential Life Lost (to age 75) from Intestinal Infections by Age, Race, and Sex in the United States, 2004

Intestinal Infections

ICD-9 001-009

Age-Adjusted Rates of Ambulatory Care Visits and Hospital Discharges With All-Listed Diagnoses of Intestinal Infections in

the United States, 1979–2004

SOURCE: National Ambulatory Medical Care Survey, National Hospital Ambulatory Medical Care Survey, and National Hospital Discharge Survey

Age-Adjusted Rates of Deaths From Intestinal Infections in the United States,

1979–2004

SOURCE: Vital Statistics of the United States

Most Costly Prescriptions for Intestinal Infections

Drug Rx # Rx % Retail cost ($) Cost %

Levofloxacin 1,265,368 16.7% 109,871,828 31.1%

Ciprofloxacin 670,080 8.8% 88,932,185 25.2%

Prochlorperazine 1,947,888 25.7% 40,064,734 11.3%

Vancomycin 17,802 0.2% 27,525,530 7.8%

Moxifloxacin 322,722 4.3% 27,432,212 7.7%

Promethazine 640,117 8.5% 23,243,001 6.6%

Gatifloxacin 201,430 2.7% 15,340,499 4.3%

Metronidazole 662,700 8.7% 7,443,865 2.1%

Diphenoxylate 285,934 3.8% 4,697,608 1.4%

Loperamide 154,837 2.0% 1,828,348 0.5%

Total top 10 6,168,878 81.4% $346,379,810 98.0%

Source: Verispan

Number of Cases and Incidence Rate of Colorectal Cancer by Age, Race/Ethnicity, and Sex, 2004

SOURCE: Surveillance, Epidemiology, and End Results (SEER) Program

Age-Adjusted Incidence Rate and 5-Year Survival Rate for Colorectal Cancer, 1979–2004

SOURCE: National Ambulatory Medical Care Survey, National Hospital Ambulatory Medical Care Survey, and

National Hospital Discharge Survey

Direct, Indirect, and Total Costs of Digestive Diseases in the United States, 2004

Direct Costs of Digestive Diseases in the United States, 2004 (continued)

Indirect Costs of Digestive Diseases in the United States, 2004 (continued)

Characteristics of Endoscopy Sites, 2001–2005, in the National Endoscopy Database

Number of Endoscopic Procedures at “Stable” Sites (N=36) by Year, 2001–2005

Number of Colonoscopies at “Stable” Sites (N=36) by Age (Years) and Year

Colonoscopy: Top Five Indications, 2001–2005 (N=542,650)

Indications are not mutually exclusive.

Colonoscopy: Top Five Findings in the Total Population and Persons at Routine Risk, 2001–2005

Findings are not mutually exclusive

Colonoscopy Findings in Persons at Routine Risk by Age, 2001–2005

Diverticulosis

Normal