OBJECTIVES: This study aims to assess health utilities and willingness to pay (WTP) among patients with coeliac disease (CD) and to determine the potential impact of gluten-free diet (GFD) on these health outcomes.

METHODS: In 2020-21, a cross-sectional online survey was carried out among CD patients aged 18 years or over through relevant social media sites in Hungary. Patients were asked to evaluate their current health and three hypothetical health states defined based on dietary adherence using visual analogue scale (VAS), 10-year time trade-off (TTO) and WTP. The Gastrointestinal Symptom Rating Scale (GSRS) was used to assess gastrointestinal complaints. Determinants of VAS, TTO and WTP values were analysed using multivariate regressions.

RESULTS: Responses of 312 CD patients following a GFD were analysed (mean±SD age 35.8±11.5 years and 70.2% female). Mean VAS utilities for current health, ‘CD with strict adherence to GFD’, ‘CD with loose adherence to GFD’ and ‘CD without GFD’ hypothetical health states were 0.80±0.19, 0.85±0.16, 0.62±0.20 and 0.37±0.26, respectively. Corresponding mean TTO utilities were higher: 0.90±0.19, 0.91±0.20, 0.87±0.23 and 0.76±0.29. Mean annual WTP values for returning to full health were as follows: 845±1,077, 648±1,002, 862±1,135 and 1,251±1,496 euro. Patients with more severe gastrointestinal symptoms (GSRS) provided lower VAS and TTO utilities, and higher WTP values (p<0.05). For current health, women were willing to trade less life-years in the TTO and pay less in order to regain full health (p<0.05). Older age at diagnosis was associated with lower VAS and higher WTP values (p<0.05).

CONCLUSIONS: This study provides a better understanding of the burden of CD and its impact on patients’ health-related quality of life. Strict adherence to the GFD may result in substantial health gains. Utilities and WTP results from this study can be used to estimate benefits of GFD in cost-utility and cost-benefit analyses.