Health-Care Utilization, Costs, and the Burden of Disease Related to Eosinophilic Esophagitis in the United States

OBJECTIVES: Eosinophilic esophagitis (EoE) has rapidly become a major cause of upper GI morbidity, but health-care costs related to EoE have not been described. This study aimed to estimate EoE-related health-care costs and utilization in the United States. METHODS: We performed a study on health-care utilization of EoE cases compared with age- and sex-matched controls using administrative claims data, representative of the commercially insured population in the United States. Cases of EoE were identified using a previously validated definition. We assessed inpatient, outpatient, emergency department, outpatient prescription, and endoscopy-related costs for patients with EoE, and estimated total costs related to EoE extrapolated to the US population. RESULTS: We identified 8,135 cases of EoE and 32,540 controls. The median total annual cost per EoE case was $3,304 compared with $1,001 for controls (P<0.001). For EoE, the median costs included $2,508/year for outpatient visits, $157 for endoscopies, and $325 for pharmacy claims, compared with $699, $0, and $76 for controls (P<0.001 for all). The overall median cost associated with EoE was $2,302/year/patient. Total costs in the United States ranged from $503 million to $1.36 billion/year, depending on the prevalence estimate, with costs attributable to EoE ranging from $350 to $947 million/year. CONCLUSIONS: Patients with EoE have an estimated annual health-care cost of as much as $1.4 billion in the United States. This represents a remarkable burden of disease for an entity that was essentially unknown two decades ago. These cost data can be used by policy makers to guide resource allocation.