OBJECTIVES: Eosinophilic esophagitis (EoE) has rapidly become a major cause of upper gastrointestinal morbidity and associated financial burden. Related evidence on healthcare resource utilization (HCRU) and costs is sparse. We aimed to evaluate HCRU and costs in patients with EoE.

METHODS: This matched case-control study used US medical and pharmacy claims from the Optum Clinformatics database (1/1/08–9/30/20) to identify patients with EoE (cases) and controls (no EoE). Index date was defined as the date of first EoE diagnosis (index period: 1/1/09–9/30/19). Cases with ≥2 EoE diagnostic claims and continuous enrollment ≥1 year before and after the index date were eligible. Incidence density sampling was used to match 1:4 by age, sex, region, and Charlson Comorbidity Index. Inpatient, outpatient, emergency room, and pharmacy settings were evaluated. Baseline characteristics were analyzed for EoE matched cohorts. All-cause costs per patient per month (PPPM) and HCRU visits (1000 patients per month [1000PPM]) were compared. A generalized linear model estimated the effect of EoE on HCRU and costs.

RESULTS: We identified 13,129 EoE cases and 43,338 matched controls (mean age 37 years, 65% male). EoE cases had higher costs versus controls ($800.39 vs $402.81 PPPM) and more HCRU visits (1986.2 vs 1168.4 1000PPM) at baseline and at 12 months (costs: $1184.73 vs $463.25 PPPM; visits: 2535.8 vs 1220.3 1000PPM). Incremental medical costs for EoE cases were $581.15 PPPM, primarily driven by outpatient costs ($349.22 PPPM). Pharmacy ($75.34 PPPM), inpatient ($57.51 PPPM), and emergency room (ER) ($10.67 PPPM) costs also were higher for EoE cases. Additionally, EoE was associated with 388.8 more outpatient visits, 14.7 more ER visits, and 2.8 more inpatient visits (1000PPM). All incremental effects were statistically significant.

CONCLUSION: Patients with EoE experience significantly higher economic burden as evidenced by higher total costs and HCRU across settings, especially in the outpatient setting.