BACKGROUND:: The usual onset of Crohn's disease (CD) is between 15 and 30 years of age, thus affecting people during their most economically productive period in life. METHODS:: This study intended to estimate societal costs and health-related quality of life (HRQoL) in Swedish patients in different stages of CD. Cross-sectional data on disease activity (measured with the Harvey-Bradshaw Index [HBI]), direct medical resource use, work productivity, and HRQoL (assessed using the 15D instrument) were collected for 420 patients by questionnaires to patients, to the treating physician, and from medical records. Based on HBI, current treatment, and response to treatment, patients were classified into the following disease states: Remission, Response, Active, Refractory, and Surgery. RESULTS:: The average 4-week cost per patient in 2007 was estimated at euro721 (USD 988), of which 64% was due to lost productivity. The total 4-week cost of care was euro255 (USD 349) in Remission, euro831 (USD 1138) in Response, euro891 (USD 1220) in Active, euro1360 (USD 1864) in Refractory, and euro16984 (USD 23269) in Surgery. HBI was the most important predictor of costs of care-a 1-point increase in HBI increased total costs by 25% (P