Abstract
This paper proposes a first monetary measure of the private costs of celiac disease, including intangible costs (physical symptoms, logistical constraints, etc.) in Switzerland. This auto-immune disease damages the intestine when patients ingest gluten. The only treatment currently available is a gluten-free diet, which implies great nutritional constraints. To get a monetary equivalent of the costs borne by celiac patients, we used a contingent valuation. The scenario suggested to celiac patients a treatment in form of a daily pill, which would allow them to eat normally and avoid any physical pain from celiac disease. Mean Willingness To Pay (WTP) for the treatment is found to be around CHF 87 (approx. USD 87) per month. WTP is positively influenced by direct and indirect costs of the disease. Oppositely, individuals, who find the gluten-free diet healthier are willing to pay less. Finally, unlike symptoms before diagnostic, the current presence or intensity of physical symptoms are found to be insignificant. The latter result can be explained by the fact that, individuals facing stronger symptoms are more likely to adhere strictly to the GFD and hence to reduce their frequency.
Highlights
Celiac disease is a chronic auto-immune disease that appears in genetically predisposed individuals
We provide coefficients and prediction of willingness to pay (WTP) using Generalized Linear Model (GLM) models as well as WTP estimates resulting from the Kaplan–Meier non-parametric estimator [2]
Some debriefing questions suggest that respondents did not answer completely rationally or did not fully understand some questions. When they were asked a follow-up question of how much they would pay if the gluten-free diet did not imply an additional cost, the difference between the first and the second answer was not necessarily equal to the amount they had indicated as costs for the diet
Summary
Celiac disease is a chronic auto-immune disease that appears in genetically predisposed individuals. It causes an atrophy of the intestinal villi in reaction to the ingestion of gluten, contained in wheat, barley, rye, and their derivatives [17]. Celiac disease comes with a variety of intestinal and extraintestinal symptoms. Its classical presentation generally appears at the infant’s age, when gluten is first introduced in the diet. The disease is more likely to show atypical symptoms. It is estimated that about 1% of the European population suffers from celiac disease, a prevalence that seems to be increasing in Western countries [34]. As the symptoms are varied, the Switzerland in Business Administration (HEG-Genève), Geneva, Switzerland disease is frequently underdiagnosed. According to Catassi et al [14], only 1 case out of 3–5 is diagnosed
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