Eosinophilic Esophagitis-Related Healthcare Resource Utilization: A Retrospective Cohort Study of US Health Insurance Claims Data
Author(s)
Benjamin D Gold, MD1, Elizabeth T. Jensen, PhD2, bridgett Goodwin, PhD3, Echo Liu, PhD3, Michael Kim, PharmD4, Taylor T. Schwartz, MPH5, Carolyn R. Schaeffer-Koziol, PhD3, Brian Terreri, PharmD3, Alan P. Baptist, MD, MPH6;
1GI Care for Kids, Children’s Center for Digestive Healthcare, LLC, Atlanta, GA, USA, 2Department of Epidemiology and Prevention and Internal Medicine, Gastroenterology Section, Wake Forest University School of Medicine, Winston-Salem, NC, USA, 3Takeda Pharmaceuticals USA, Inc., Lexington, MA, USA, 4Takeda Pharmaceuticals USA, Inc., Chicago, IL, USA, 5Avalere Health, Washington, DC, USA, 6Division of Allergy and Clinical Immunology, Henry Ford Health and Michigan State University Health Sciences, Detroit, MI, USA
1GI Care for Kids, Children’s Center for Digestive Healthcare, LLC, Atlanta, GA, USA, 2Department of Epidemiology and Prevention and Internal Medicine, Gastroenterology Section, Wake Forest University School of Medicine, Winston-Salem, NC, USA, 3Takeda Pharmaceuticals USA, Inc., Lexington, MA, USA, 4Takeda Pharmaceuticals USA, Inc., Chicago, IL, USA, 5Avalere Health, Washington, DC, USA, 6Division of Allergy and Clinical Immunology, Henry Ford Health and Michigan State University Health Sciences, Detroit, MI, USA
Presentation Documents
OBJECTIVES: To assess eosinophilic esophagitis (EoE)-related healthcare resource utilization (HCRU) among patients in the USA.
METHODS: This retrospective, longitudinal cohort study analyzed US health insurance data from the Inovalon closed claims (ICC) database and the 100% sample of Medicare Fee-For-Service (MFFS) parts A/B/D claims and enrollment data (January 1, 2016-December 31, 2022). Eligible patients (≥11 years old) had ≥2 claims (≥30 days apart) for EoE in the index period (January 1, 2017-December 31, 2021 [index date=date of first claim for EoE]) and had continuous enrollment in medical and pharmacy benefits for ≥12 months before and after their index date (baseline and follow-up, respectively). Patients with a post-index diagnosis of eosinophilic gastritis/gastroenteritis were excluded. EoE-related hospitalizations and emergency department (ED), outpatient and post-acute care visits were assessed.
RESULTS: Data from 37,809 and 15,109 patients (ICC and MFFS, respectively) were analyzed. Mean (standard deviation, SD) ages of patients (ICC and MFFS) were 38.1 (16.7) and 66.8 (13.2) years, respectively; >50% of patients were male (ICC and MFFS) and 90.3% were White (MFFS only). During 12-months of follow-up, EoE-related HCRU (proportion of patients with ≥1 visit and mean [SD] number of visits/patient/month) from ICC was: hospitalizations, 1.6% and 0.02 (0.17); ED, 3.7% and 0.04 (0.24); ED-food impactions, 1.5% and 0.02 (0.13); outpatient physician office, 98.1% and 3.00 (4.40); and any other outpatient, 42.0% and 0.69 (1.12). Corresponding MFFS data were: hospitalizations, 2.7% and 0.03 (0.22); ED, 2.3% and 0.03 (0.18); ED-food impactions, 1.0% and 0.01 (0.10); outpatient physician office, 95.6% and 3.12 (2.53); and any other outpatient, 32.3% and 0.56 (1.08). Proportions of patients with ≥1 visit for post-acute care were ≤0.7% (ICC and MFFS).
CONCLUSIONS: EoE represents a substantial healthcare burden in adolescents and adults in the USA, driven by frequent outpatient visits; food impactions were a leading cause of ED admissions.
METHODS: This retrospective, longitudinal cohort study analyzed US health insurance data from the Inovalon closed claims (ICC) database and the 100% sample of Medicare Fee-For-Service (MFFS) parts A/B/D claims and enrollment data (January 1, 2016-December 31, 2022). Eligible patients (≥11 years old) had ≥2 claims (≥30 days apart) for EoE in the index period (January 1, 2017-December 31, 2021 [index date=date of first claim for EoE]) and had continuous enrollment in medical and pharmacy benefits for ≥12 months before and after their index date (baseline and follow-up, respectively). Patients with a post-index diagnosis of eosinophilic gastritis/gastroenteritis were excluded. EoE-related hospitalizations and emergency department (ED), outpatient and post-acute care visits were assessed.
RESULTS: Data from 37,809 and 15,109 patients (ICC and MFFS, respectively) were analyzed. Mean (standard deviation, SD) ages of patients (ICC and MFFS) were 38.1 (16.7) and 66.8 (13.2) years, respectively; >50% of patients were male (ICC and MFFS) and 90.3% were White (MFFS only). During 12-months of follow-up, EoE-related HCRU (proportion of patients with ≥1 visit and mean [SD] number of visits/patient/month) from ICC was: hospitalizations, 1.6% and 0.02 (0.17); ED, 3.7% and 0.04 (0.24); ED-food impactions, 1.5% and 0.02 (0.13); outpatient physician office, 98.1% and 3.00 (4.40); and any other outpatient, 42.0% and 0.69 (1.12). Corresponding MFFS data were: hospitalizations, 2.7% and 0.03 (0.22); ED, 2.3% and 0.03 (0.18); ED-food impactions, 1.0% and 0.01 (0.10); outpatient physician office, 95.6% and 3.12 (2.53); and any other outpatient, 32.3% and 0.56 (1.08). Proportions of patients with ≥1 visit for post-acute care were ≤0.7% (ICC and MFFS).
CONCLUSIONS: EoE represents a substantial healthcare burden in adolescents and adults in the USA, driven by frequent outpatient visits; food impactions were a leading cause of ED admissions.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE238
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Gastrointestinal Disorders