title: The economics of coeliac disease: a population-based study.
abstract: 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.
authors.affiliation: Division of Health Care Policy & Research, College of Medicine, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: K H
authors.initials: KH
authors.lastname: Long
authors.forename: A
authors.initials: A
authors.lastname: Rubio-Tapia
authors.forename: A E
authors.initials: AE
authors.lastname: Wagie
authors.forename: L J
authors.initials: LJ
authors.lastname: Melton
authors.forename: B D
authors.initials: BD
authors.lastname: Lahr
authors.forename: C T
authors.initials: CT
authors.lastname: Van Dyke
authors.forename: J A
authors.initials: JA
authors.lastname: Murray
mesh_terms: 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
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