The economics of coeliac disease: a population-based study.
BACKGROUND
Despite increasing prevalence, the economic implications of coeliac disease are just emerging.


OBJECTIVE
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.
Long
K H
KH
Division of Health Care Policy & Research, College of Medicine, Mayo Clinic, Rochester, MN 55905, USA.
Rubio-Tapia
A
A
Wagie
A E
AE
Melton
L J
LJ
Lahr
B D
BD
Van Dyke
C T
CT
Murray
J A
JA
D000328:Adult; D002446:Celiac Disease / Q000191:economics* / Q000453:epidemiology; D017281:Cost of Illness; D004469:Economics, Hospital; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D015995:Prevalence
Mayo Clin Proc. 1996 Mar;71(3):266-74
8594285
Acta Gastroenterol Latinoam. 2005;35(1):37-55
15954735
J Hum Nutr Diet. 2007 Oct;20(5):423-30
17845376
Scand J Gastroenterol. 2005 Jan;40(1):15-9
15841709
Gastroenterology. 2004 Jun;126(7):1721-32
15188167
Aliment Pharmacol Ther. 2010 Apr;31(8):901-10
20096017
Dig Dis Sci. 2004 Nov-Dec;49(11-12):1808-14
15628708
J Clin Gastroenterol. 1996 Jul;23(1):21-3
8835894
Clin Gastroenterol Hepatol. 2003 Jan;1(1):19-27
15017513
Scand J Gastroenterol. 2009;44(8):933-8
19492246
Scand J Gastroenterol. 2005 Feb;40(2):183-7
15764149
Arch Dis Child. 1990 Aug;65(8):909-11
2205160
Dig Dis Sci. 2008 Mar;53(3):680-8
17934849
N Engl J Med. 1997 Nov 13;337(20):1466-70
9380105
J Insur Med. 2008;40(3-4):218-28
19317331
Vasc Med. 2008 Aug;13(3):251-3
18687763
Med Decis Making. 2009 May-Jun;29(3):282-90
19270107
J Clin Epidemiol. 1992 Jun;45(6):613-9
1607900
Aliment Pharmacol Ther. 2004 Jun 1;19(11):1199-210
15153173
Arch Intern Med. 2003 Feb 10;163(3):286-92
12578508
JAMA. 2001 Jan 3;285(1):60-6
11150110
Gastroenterology. 2009 Jul;137(1):88-93
19362553
Gastroenterology. 2006 Dec;131(6):1981-2002
17087937
Dig Liver Dis. 2002 Aug;34(8):547-52
12502210
Am J Gastroenterol. 2001 Jan;96(1):126-31
11197241
Osteoporos Int. 2002;13(4):323-30
12035765
Dig Dis Sci. 2005 Apr;50(4):796-805
15844721
Aliment Pharmacol Ther. 2008 Nov 1;28(9):1042-66
18671779
J Health Serv Res Policy. 1998 Oct;3(4):233-45
10187204
Gastroenterology. 2009 Jan;136(1):99-107; quiz 352-3
18996383
N Engl J Med. 2007 Oct 25;357(17):1731-43
17960014
Aliment Pharmacol Ther. 2009 May 15;29(10):1131-6
19245681
Dig Dis Sci. 2001 Nov;46(11):2510-4
11713962
Lancet. 2000 Jul 15;356(9225):203-8
10963198
Can J Diet Pract Res. 2008 Fall;69(3):147-50
18783640