Dellon ES, Goodwin B, Liu Y, de los Santos B, Korgaonkar S, Meyers J, Schaeffer-Koziol CR, Terreri B, Shah ED. Healthcare resource utilization and associated costs in patients with eosinophilic esophagitis: a retrospective cohort study of US health insurance claims data. Poster presented at the Digestive Disease Week (DDW) 2025; May 3, 2025. San Diego, CA.

INTRODUCTION: Eosinophilic esophagitis (EoE) represents a substantial burden to healthcare systems; however, the economic burden on patients is understudied. We report all-cause healthcare resource utilization (HCRU) and cost data for patients with EoE in the USA from the perspective of payers and patients.

METHODS: This was a retrospective, observational cohort study that examined US health insurance claims data from the Merative™ MarketScan® Commercial, Medicare Supplemental, and Medicaid databases (July 1, 2020–June 30, 2023). Patients were eligible for inclusion if they had ≥1 inpatient or outpatient claim with a diagnosis code for EoE (International Classification of Diseases 10th 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 were excluded if they had a diagnosis code for eosinophilic gastritis/eosinophilic gastroenteritis (ICD-10-CM: K52.81) post-index. Baseline demographics were reported, and all-cause HCRU and healthcare costs (payer costs and payer plus patient costs) were captured during the baseline and follow-up periods.

RESULTS: For the 19,169 patients with EoE included, the mean (standard deviation [SD]) age was 35.8 (18.5) years. Most patients were male (60.3%); 73.7% were commercially insured and the remainder were enrolled via Medicaid (23.8%) or Medicare (2.4%) (Table 1). HCRU (proportion of patients who had ≥1 visit [i.e. ≥1 claim]) was slightly higher during the follow-up than baseline period for most visit types, except for emergency department (ED) visits (30.0% vs 27.6%) and urgent care visits (21.2% vs 21.0%) (Table 2). The median number of claims per patient was slightly higher during the follow-up than baseline period for ambulatory surgical center visits (4 vs 5), outpatient hospital visits (14 vs 18), physician office visits (15 vs 17) and prescription claims (13 vs 15). Annual mean (SD) total healthcare costs per patient for the payer and payer plus patient perspectives at baseline were $12,621 ($31,626) and $15,185 ($37,843), respectively, and increased to $15,704 ($39,273) and $18,636 ($42,862), respectively, during the follow-up period; the increases were primarily driven by inpatient visits, outpatient hospital visits and pharmacy costs. Annual mean costs per patient were higher for the follow-up than baseline period, except for ambulatory surgical center, ED, urgent care, home and telemedicine visits.

DISCUSSION: These findings demonstrate a substantial healthcare burden for patients with EoE, which was increased further by the addition of patient costs. HCRU and costs increased slightly after a diagnosis of EoE, which may be attributed to an increase in routine assessments and prescriptions.