Economic burden of eosinophilic esophagitis in the first year after diagnosis in Spain: A direct medical cost analysis.
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Rodriguez-Alcolado Leticia, Aranda-Reneo Isaac, Casabona Sergio, Pérez-Martínez Isabel, Guagnozzi Danila, Gutiérrez-Junquera Carolina, Amorena Edurne, Guardiola-Arévalo Antonio, de la Peña-Negro Luisa, Jhon Leonardo Blas, García-Dionisio Sandra López, Fernández-Pacheco Jennifer, Barrio Jesús, Fernández-Fernández Sonia, Betoré Elena, de la Riva Susana, Teruel Sánchez-Vegazo Carlos, Rodríguez-Oballe Juan Armando, Naves Juan Enrique, Bisso-Zein Juan K, Carrión Silvia, Suárez Adolfo, Llerena-Castro Ronald, García-Díaz Alejandro, Nantes-Castillejo Óscar, Granja-Navacerrada Alicia, Perelló Antonia, Álvarez-García Marta, Santander Cecilio, Laserna-Mendieta Emilio J, Oliva-Moreno Juan, Lucendo Alfredo J
Аннотация
OBJECTIVE: To assess contemporaneous direct medical costs during the first year after EoE diagnosis in Spain to identify key cost determinants and assess variables that could affect these costs.
METHODS: Observational study of Spanish participants in the EUREOS EoE CONNECT registry with incident EoE in 2017-2018. We assessed average costs/year in Euros for endoscopic procedures, out-patient visits, medication, emergency room visits and hospitalizations, 2018 being our base year. Official regional tariffs were used to estimate direct costs from a healthcare provider perspective; official price lists were used for drug therapies. Cost differences and determinants were assessed with multivariate models.
RESULTS: The mean annual direct cost of EoE per person among 302 patients (76.5% male, 77.5% adults) was €1,842.07 (SD €795.69). Endoscopic procedures accounted for 68% of this, followed by outpatient visits (15.9%) and drug prescriptions (10.8%). Cost was higher for pediatric compared to adult patients (€2,101.51 vs. €1,784.29, p < 0.01), for those with higher EREFS score (€1,979.36 vs. €1,794.49; p < 0.01), and in high-volume hospitals (€1,941.48 vs. €1,723.92; p = 0.02). Early response to first-line treatment reduced annual costs by -€368.95 (p < 0.01), by avoiding further medical procedures.
CONCLUSION: First year after EoE diagnosis produces significant direct costs in Spain, mainly due to endoscopic procedures, which are reduced in early responders to first-line therapy. Research for non-invasive methods for EoE assessment and identifying predictors of response are, therefore, key.