407 Healthcare Resource Utilization in the 12 Months After Diagnosis in Patients With Eosinophilic Esophagitis Compared With a Matched Cohort

Abstract

INTRODUCTION: Eosinophilic esophagitis (EoE) is a chronic, immune-mediated disease of the esophagus, characterized by esophageal dysfunction and eosinophil-predominant inflammation. Currently, no licensed therapies exist for EoE in the USA, and data on the real-world burden of EoE on healthcare systems are limited. This retrospective study aimed to investigate healthcare resource utilization (HCRU) in patients with EoE compared with matched controls without EoE in the USA. METHODS: The US healthcare claims databases Truven Health MarketScan Commercial Claims and Encounters and the Medicare Supplemental database were used to identify patients diagnosed with EoE from January 2008 to September 2016. HCRU was recorded from the date of diagnosis (index date) throughout the continuously enrolled 12-month study period. A cohort of individuals without EoE was matched 1:1 for age, sex, geographic region, Charlson Comorbidity Index during the 12 months before the index date, and distribution of time from eligibility start date to index date. Logistic regression models were used to compare HCRU between cohorts. RESULTS: Each cohort included 16 094 individuals. Mean age in each cohort was 34.3 (SD: 17.9) years; 65.0% were men. Table 1 shows the frequency of HCRU. Of patients with EoE, 73.9% underwent a diagnostic endoscopy during the study period vs 1.7% in the matched cohort. All-cause inpatient admissions occurred significantly more frequently in patients with EoE than in the matched cohort (P < 0.0001). Patients with EoE were significantly more likely to have an outpatient visit than matched controls, including visits to a gastroenterologist or a psychologist (P < 0.0001). Overall, 26.2% of patients with EoE had ≥1 ER visit in the 12-month period, compared with 12.9% of controls. In patients with EoE, these were most commonly associated with food impaction (6.7% of patients; 25.7% of ER visits in patients with EoE vs 0.34% in matched controls) and esophageal stricture (3.2% of patients; 12.1% of ER visits in patients with EoE vs 0.05% in matched controls). CONCLUSION: Inpatient admissions and outpatient and ER visits were more frequent in patients with EoE compared with matched controls, highlighting the ongoing burden EoE imposes on patients and healthcare systems. In particular, ER visits for food impaction and esophageal stricture comprise 38% of ER visits for patients with EoE compared with < 0.5% for those without EoE. The lack of an approved treatment for EoE in the USA may contribute to this burden.