Healthcare resource utilization and cost in pediatric celiac disease: A case-control study using German insurance data.

OBJECTIVES: Celiac disease (CeD) is a life-long systemic immune-mediated disorder. Data on burden and cost of CeD in children are scarce. We assessed healthcare resource utilization (HCRU) and cost of healthcare services of newly diagnosed children in Germany. METHODS: This retrospective case-control study covered a period from 2014 to 2021, using German Statutory Health Insurance claims data from the "Institute for Applied Health Research Berlin" (InGef). The HCRU (hospitalizations, outpatient contacts, outpatient drug prescriptions) and cost of CeD patients aged <6 (group 1) and 6-11 years (group 2) between 2017 and 2019 were compared with matched non-CeD individuals (1:5 matching by age, sex, Charlson Comorbidity Index, and region) during the time of diagnosis and 2 years thereafter. Case definition required ≥1 diagnosis of CeD (ICD-10-GM K90.0) as inpatient or ≥2 recorded diagnoses as outpatient plus ≥1 CeD-related serological test, and no recorded CeD diagnoses during the 3-year preobservation period. RESULTS: We identified 410 CeD cases resulting in incidence rates of 32.5 and 34.1 per 100,000 individuals in groups 1 and 2, respectively. During time of diagnosis and 2 years thereafter, CeD patients had increased HCRU (median) compared to their controls (two more hospitalizations, almost three-times more outpatient contacts, and 3-4 more prescriptions), resulting in higher total costs (median difference €1677 and €1343 in group 1 and 2, respectively) (all p < 0.001). CONCLUSIONS: These findings underscore the substantial burden of CeD on patients and healthcare systems, highlighting the need for targeted interventions and effective management strategies to mitigate this impact.