Title: The cost of illness analysis of inflammatory bowel disease
Version: 1 Date: 25 Sep 2022
Reviewer's report:
Dear Authors,
It was a pleasure to read your manuscript entitled "the cost of illness analysis of inflammatory
bowel disease". I comment the authors on their effort to analyze the challenging subject of cost
of IBD in the new era of biologics that has altered the natural course of these disease entities.
General
This is a well intended and timely study given the rapid evolution of biologics and other new
treatment modalities in IBD.There is a much needed information on economic burden of IBD in
the developing world.  However I am afraid this study suffers from severe heterogeneity given
the methods. The narration also needs significant revision to address the errors of language
struture.
Major
#1 As the  cost analysis involved self reported expenses,  this study could suffer from significant
heterogeneity.  This could further be affected as the study found that about 60% of the costs
were attributable to indirect expenses which could vary widely based on available resources and
purchasing power of the individuals in the study population.
#2 Cost diary method is known to have inconsistencies when compared to insurance reported
cost data. It is understood that the healthcare infrastructure in Iran, where this study was
conducted is different from Europe or the United states were payor systems are more well defined
and data easily available  for analysis. Hence I am not sure if there could be a better method.
#3 The authors mention that some of the data was extrapolated to a year from 3 month data. For
example the costs related to medications and physician visits. As these could vary over time this
could lead to significant  errors in the final estimate.
#4 Significant revision of narration is required before this manuscript can be considered ready
for publication. If I may so suggest, review by a native English speaker familiar with scientific
writing would greatly aid in this process.
Minor
#1 Some of the statements need more fact-checking and correlation with data in the relevant
demographics. For example, in the  abstract, the authors state that IBD is a condition involving
young adults. However it is a condition known to have  a bimodal incidence pattern and affects
individuals across all age groups.
# 2 Authors need to verify the accuracy of data. For example in Table 1 showing demographics,
the numbers based on age group do not add up to the total (167 Vs 168)
Title: The cost of illness analysis of inflammatory bowel disease
Version: 1 Date: 25 Sep 2022
Reviewer's report:
Dear Authors,
It was a pleasure to read your manuscript entitled "the cost of illness analysis of inflammatory
bowel disease". I comment the authors on their effort to analyze the challenging subject of cost
of IBD in the new era of biologics that has altered the natural course of these disease entities.
General
This is a well intended and timely study given the rapid evolution of biologics and other new
treatment modalities in IBD.There is a much needed information on economic burden of IBD in
the developing world.  However I am afraid this study suffers from severe heterogeneity given
the methods. The narration also needs significant revision to address the errors of language
struture.
Major
#1 As the  cost analysis involved self reported expenses,  this study could suffer from significant
heterogeneity.  This could further be affected as the study found that about 60% of the costs
were attributable to indirect expenses which could vary widely based on available resources and
purchasing power of the individuals in the study population.
#2 Cost diary method is known to have inconsistencies when compared to insurance reported
cost data. It is understood that the healthcare infrastructure in Iran, where this study was
conducted is different from Europe or the United states were payor systems are more well defined
and data easily available  for analysis. Hence I am not sure if there could be a better method.
#3 The authors mention that some of the data was extrapolated to a year from 3 month data. For
example the costs related to medications and physician visits. As these could vary over time this
could lead to significant  errors in the final estimate.
#4 Significant revision of narration is required before this manuscript can be considered ready
for publication. If I may so suggest, review by a native English speaker familiar with scientific
writing would greatly aid in this process.
Minor
#1 Some of the statements need more fact-checking and correlation with data in the relevant
demographics. For example, in the  abstract, the authors state that IBD is a condition involving
young adults. However it is a condition known to have  a bimodal incidence pattern and affects
individuals across all age groups.
# 2 Authors need to verify the accuracy of data. For example in Table 1 showing demographics,
the numbers based on age group do not add up to the total (167 Vs 168)
Please review this paper.
user
Title: The cost of illness analysis of inflammatory bowel disease
Version: 1 Date: 25 Sep 2022
Reviewer's report:
Dear Authors,
It was a pleasure to read your manuscript entitled "the cost of illness analysis of inflammatory
bowel disease". I comment the authors on their effort to analyze the challenging subject of cost
of IBD in the new era of biologics that has altered the natural course of these disease entities.
General
This is a well intended and timely study given the rapid evolution of biologics and other new
treatment modalities in IBD.There is a much needed information on economic burden of IBD in
the developing world.  However I am afraid this study suffers from severe heterogeneity given
the methods. The narration also needs significant revision to address the errors of language
struture.
Major
#1 As the  cost analysis involved self reported expenses,  this study could suffer from significant
heterogeneity.  This could further be affected as the study found that about 60% of the costs
were attributable to indirect expenses which could vary widely based on available resources and
purchasing power of the individuals in the study population.
#2 Cost diary method is known to have inconsistencies when compared to insurance reported
cost data. It is understood that the healthcare infrastructure in Iran, where this study was
conducted is different from Europe or the United states were payor systems are more well defined
and data easily available  for analysis. Hence I am not sure if there could be a better method.
#3 The authors mention that some of the data was extrapolated to a year from 3 month data. For
example the costs related to medications and physician visits. As these could vary over time this
could lead to significant  errors in the final estimate.
#4 Significant revision of narration is required before this manuscript can be considered ready
for publication. If I may so suggest, review by a native English speaker familiar with scientific
writing would greatly aid in this process.
Minor
#1 Some of the statements need more fact-checking and correlation with data in the relevant
demographics. For example, in the  abstract, the authors state that IBD is a condition involving
young adults. However it is a condition known to have  a bimodal incidence pattern and affects
individuals across all age groups.
# 2 Authors need to verify the accuracy of data. For example in Table 1 showing demographics,
the numbers based on age group do not add up to the total (167 Vs 168)
assistant