OBJECTIVES: This study assessed eosinophilic esophagitis (EoE)-related healthcare resource utilization (HCRU) and associated costs for patients with EoE in the USA from the perspective of payers and patients.
METHODS: This retrospective, observational cohort study examined US health insurance claims data from the Merative MarketScan Commercial, Medicare Supplemental and Medicaid databases (July 1, 2020–June 30, 2023). Eligible patients had ≥1 inpatient or outpatient claim with a diagnosis code for EoE (International Classification of Diseases, Tenth Revision, Clinical Modification [ICD-10-CM]: K20.0 [index date]) and 12 months of continuous health plan enrollment before and after the index date (baseline and follow-up periods, respectively). Patients with a diagnosis code for eosinophilic gastritis/gastroenteritis (ICD-10-CM: K52.81) post-index were excluded.
RESULTS: Overall, 19,169 patients with EoE were identified: mean (standard deviation [SD]) age 35.8 (18.5) years; 60.3% male; 73.7% commercially insured. EoE-related HCRU (proportion of patients who had ≥1 visit days) was higher during the follow-up than baseline period for most visit types, except for emergency department (17.1% vs 14.1%) and urgent care visits (2.1% vs 1.7%), where utilization was higher during the baseline period. The median number of claims per patient was slightly higher during the follow-up than baseline period for prescription claims (4 vs 5). The annual mean (SD) EoE-related total healthcare cost per patient at baseline was US$3729 (US$8594) and increased to US$5331 (US$10,217) during the follow-up period; the increase was primarily driven by outpatient hospital visits, pharmacy costs and physician home visits. Except for inpatient costs and emergency department visits, annual mean costs per patient were higher for the follow-up than baseline period. EoE-related costs accounted for 24.6% of all-cause healthcare costs at baseline and 28.6% of those during follow-up.
CONCLUSION: EoE represents a substantial healthcare burden; the increases in HCRU and costs after diagnosis may be attributed to increases in routine assessments and prescriptions.
