title: Direct Costs in Patients with Celiac Disease in the USA: A Retrospective Claims Analysis.
abstract: Celiac disease (CeD) is an autoimmune disease triggered by gluten ingestion.
  
  
  
  We assessed total direct costs burden associated with CeD in patients with CeD versus patients without CeD using administrative claims data.
  
  
  
  Patients with CeD (cases) with ≥1 occurrences of CeD diagnosis were selected at a randomly chosen date (index date) from the OptumHealth Reporting and Insights database from 01/01/1998 through 03/31/2013. Cases were continuously enrolled throughout baseline (1 year before index date) and study (1 year after index date) periods. Cases were categorized as full remission and partial remission and matched 1:1 based on age, sex, region, index date, company, and employment status. Total all-cause and CeD-related costs were calculated.
  
  
  
  A total of 12,187 cases were matched with an equal number of controls. Mean total all-cause costs were $12,217 in cases versus $4935 in controls (P < 0.0001). In full remission (N = 10,181 [83.5 %]) and partial remission (N = 2006 [16.5 %]) cases, mean total all-cause direct costs (cases versus controls) were $11,038 versus $4962 and $18,206 versus $4796, respectively. All-cause medical costs ($9839 for all cases, $8723 for full remission cases, $15,499 for partial remission cases) accounted for the majority of all-cause total costs and included outpatient costs ($6675; $6456; and $7785, respectively) and hospitalizations ($2776; $1963; and $6906, respectively). CeD-related medical costs were 13 and 27 % of all-cause medical costs for all cases and partial remission cases, respectively.
  
  
  
  Patients with CeD and partial remission of CeD incurred significantly higher (2.5 and 3.8 times) total all-cause costs compared with matched controls.
authors.affiliation: University of Chicago, 5721 S. Maryland Avenue, Chicago, IL, 60637, USA. sguandalini@peds.bsd.uchicago.edu.
authors.forename: Stefano
authors.initials: S
authors.lastname: Guandalini
authors.affiliation: AbbVie Inc., 1 N Waukegan Road, North Chicago, IL, 60064, USA.
authors.forename: Namita
authors.initials: N
authors.lastname: Tundia
authors.affiliation: AbbVie Inc., 1 N Waukegan Road, North Chicago, IL, 60064, USA.
authors.forename: Roopal
authors.initials: R
authors.lastname: Thakkar
authors.affiliation: Analysis Group, 10 Rockefeller Plaza, 15th Floor, New York, NY, 10020, USA.
authors.forename: Dendy
authors.initials: D
authors.lastname: Macaulay
authors.affiliation: Alvine Pharmaceuticals, 75 Shoreway Road, Suite B, San Carlos, CA, 94070, USA.
authors.forename: Kirk
authors.initials: K
authors.lastname: Essenmacher
authors.affiliation: AbbVie Inc., 1 N Waukegan Road, North Chicago, IL, 60064, USA.
authors.forename: Mahesh
authors.initials: M
authors.lastname: Fuldeore
mesh_terms: D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care / Q000191:economics*; D016022:Case-Control Studies; D002446:Celiac Disease / Q000191:economics* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D003365:Costs and Cost Analysis; D004180:Direct Service Costs; D005260:Female; D017048:Health Care Costs; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007348:Insurance, Health; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D012189:Retrospective Studies; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult
keywords: Celiac disease; Economic burden of disease; Gluten-sensitive enteropathy; Health care costs