Abstract Background Inflammatory bowel disease (IBD) prevalence is rising worldwide, creating major challenges for sustainable, high-quality care. In Australia alone, approximately 180, 000 people are affected, with the national economic burden projected to reach 77. 9 billion by 2035. 1 The absence of an IBD National Clinical Quality Registry (CQR) limits benchmarking and cost-effective care. This cost: benefits analysis examines the likely outcomes from scaling a nascent CQR (CCCare) into a National CQR. Methods Cost estimates were derived from published national datasets and conservative assumptions for reductions in healthcare utilisation were informed by local studies. 2, 3 Savings were modelled at three CQR sizes: current (16, 000 consumers), interim target (60, 000), and national coverage (180, 000) over a two-year period. Return on investment (ROI) was calculated using a 1 million investment for current and interim sizes and 3 million for national coverage. Social return on investment (SROI) was estimated using a conservative Quality-Adjusted Life Years (QALY) gain of 0. 03% per patient per year, 1 valued at 50, 000 per QALY. Results At current scale, CCCare CQR yields 10. 7M in direct savings (ROI: 969%). Scaling to 60, 000 consumers increases savings to 40. 1 million (ROI: 3, 909%), while national coverage projects 121. 3M in savings (ROI 3, 945%). Cost reductions were driven primarily by avoided hospitalisations and surgical episodes, with incremental contributions from outpatient care. QALY-based SROI modelling estimates up to 180 in social returns for every 1 invested at national coverage. Conclusion Scaling an IBD-specific CQR like CCCare nationally can deliver substantial ROI and SROI, by reducing costly, avoidable interventions while improving care quality. Although modelled with Australian data, the conservative parameters used are transferable across health systems. For international stakeholders, savings translate into value capture for payers through reduced diagnostic and outpatient costs, and for providers through fewer admissions and surgeries. CCCare’s participation in the Global IBD Registry (GLIDE) underscores the international relevance of ROI-positive registries, offering a scalable framework for providers, payers, and policymakers worldwide. References: 1. Crohn’s 2025. Available from: https: //crohnsandcolitis. org. au/wp-content/uploads/2025/02/State-of-the-Nation-in-IBD-Report. pdf 2. NSW Health. Health Professional and Medical Salaries (State) Award 2024 Internet. Sydney: NSW Government; 2024. Available from: https: //www. health. nsw. gov. au/careers/conditions/pages/default. aspx 3. Australian Government. AusTender Internet. Canberra: Department of Finance; 2024. Available from: https: //www. tenders. gov. au Conflict of interest: Dr. Wu, Rodger: No conflict of interest Petch, Bill: No conflict of interest Deschenes, Renee: No conflict of interest Connor, Susan Jane: Grant: Research Support: Abbvie, Agency for Clinical Innovation, Amgen, BMS, Chiesi, Celltrion, DrFalk, Ferring, Janssen, Medical Research Future Fund, Pfizer, South Western Sydney Local Health District, Sydney Partnership for Health, Research and Enterprise, Takeda and The Leona M and Harry B Helmsley Charitable Trust Personal Fees: Ad Boards: Abbvie, Amgen, BMS, Celltrion, Eli Lilly, Ferring, GSK, Janssen, Organon, Pfizer, Takeda Speaker Fees: Abbvie, Cornerstones Health, Dr Falk, Ferring, Janssen, Pfizer, Sandoz, Sydney IBD School, Takeda Educational Support: DrFalk, Sandoz, Takeda Andrews, Jane Mary: Grant: The work I will present was funded via CCCure. CCCure’s funding sources include grants for research and payments for data reports from Pharma including AbbVie, J&J, Takeda, Celltrion, Falk, Ferring, BMS, Janssen, Pfizer, Sandoz
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