S390 Estimating the Indirect and Intangible Costs Associated With Eosinophilic Esophagitis

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Introduction: Eosinophilic esophagitis (EoE) is a chronic, inflammatory disease characterized by esophageal eosinophilia and dysfunction. Indirect costs associated with EoE, such as loss of work, and intangible costs associated with reduced health-related quality of life (HRQoL) are not well documented. Methods: We used data from a retrospective, cross-sectional, qualitative study of caregivers of children and adolescents (6–17 years old) plus adults (≥18 years old) with EoE and a prospective, cross-sectional, observational study of adults with EoE and healthy adults in the USA. A human capital approach based on self-reported EoE-associated work patterns (reducing working hours or stopping work), weekly salary estimates and general employment rates was used to estimate the potential lost wages per year (yr) because of EoE. For participants who reduced their working hours, an average reduction of 25% was assumed. Estimated HRQoL loss (from a perfect score of 100) captured by the 36-item short-form survey (8 multi-item domains), was converted into EuroQoL 5-Dimension scores (EQ-5D) using an existing algorithm (Table 1). These were translated into humanistic costs based on the conservative willingness-to-pay US$50,000 per quality-adjusted life year. Results: Overall, 27 caregivers of children and adolescents, plus adults with EoE (caregivers, n = 9; adults, n = 18) and 88 adults (adults with EoE, n = 44; healthy adults, n = 44) were analyzed for indirect and intangible costs, respectively. Among participants, 22.2% (caregivers, 33.3%; adults, 16.7%) reduced their working hours and 33.3% (caregivers, 55.6%; adults, 22.2%) stopped working for pay owing to EoE (Table 1). For caregivers of children and adolescents with EoE, estimated yearly indirect costs associated with EoE were US$2473/yr because of reduced working hours and US$16,487/yr because of stopping work. Estimated yearly indirect costs for adults with EoE were US$1237/yr because of reduced working hours and US$6595/yr because of stopping work (Table 1). Estimated decreases in EQ-5D from perfect health were 11.9 and 4.5 for adults with EoE and healthy adults, respectively; the estimated intangible cost adults with EoE would willingly pay to return to a healthy status was US$3659/yr (Table 1). Conclusion: Substantial EoE-associated indirect and intangible costs are related to lost wages and HRQoL loss for caregivers of children and adolescents plus adults with EoE, demonstrating the high financial burden, and potential associated burden on HRQoL, of EoE.Table 1.: Estimated EoE-Associated Indirect And Intangible Costs For Caregivers Of Children And Adolescents Plus Adults With EoE.