The economics of coeliac disease: a population-based study

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 outpatient 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.