The economics of coeliac disease: a population-based study

Abstract

Background: Despite increasing prevalence, the economic implications of coeliac disease are just emerging.

Aims: To assess the impact of coeliac disease diagnosis on healthcare costs and the incremental costs associated with coeliac disease.

Methods: Administrative data for a population-based cohort of coeliac disease cases and matched controls from Olmsted County, Minnesota were used to compare (i) direct medical costs 1 year pre- and post-coeliac disease diagnosis for 133 index cases and (ii) 4-year cumulative direct medical costs incurred by 153 index cases vs. 153 controls. Analyses exclude diagnostic-related and out-patient pharmaceutical costs.

Results: Average total costs were reduced by $1764 in the year following diagnosis (pre-diagnosis cost of $5023 vs. $3259; 95% CI of difference: $688 to $2993). Over a 4-year period, coeliac disease cases experienced higher out-patient costs (mean difference of $1457; P = 0.016) and higher total costs than controls (mean difference of $3964; P = 0.053). Excess average total costs were concentrated among males with coeliac disease ($14,191 vs. $4019 for male controls; 95% CI of difference: $2334 to $20,309).

Conclusions: Coeliac disease-associated costs indicate a significant economic burden of disease, particularly for diseased males. Diagnosis and treatment of coeliac disease reduce medical costs of care suggesting an economic advantage to earlier detection and treatment.

FIGURE 1

The distribution of 4- year costs for CD cases, stratified by severity and clinical presentation, and for matched controls. Black lines represent the mean 4-year cost for that group or subgroup.