Burden of coeliac disease in Germany: real-world insights from a large retrospective health insurance claims database analysis.

Background: Coeliac disease (CeD) is a chronic immune-mediated disease triggered by exposure to dietary gluten in genetically predisposed individuals. The burden of CeD on patients and the healthcare system remains poorly evaluated in Germany. Objectives: To assess the healthcare resource utilisation (HCRU) and costs of diagnosed CeD patients in a German claims database. Design: A retrospective CeD case–control study was conducted using German claims data between 2017 and 2021. Methods: CeD diagnosis was defined by at least one inpatient or two outpatient diagnostic codes (International Statistical Classification of Diseases and Related Health Problems, 10th Revision, German Modification (ICD-10-GM) K90.0) within four quarters (irrespective of calendar year) for CeD during the study period. Controls (non-CeD patients) were matched in a ratio of 5:1 by age, Charlson Comorbidity Index, sex and region. HCRU (hospitalisations, outpatient visits, medication use, sick leaves) and healthcare costs (outpatient services, inpatient services, outpatient pharmaceuticals, sick leaves and aids and remedies) were compared between CeD patients and controls. Results: From the 3,352,188 patients with continuous enrolment during the study period (2017–2021), 8258 (0.25%) patients were identified as having a CeD diagnosis. The mean number of hospitalisations and outpatient visits within 5 years was 1.8- and 1.5-fold higher among matched CeD patients (n = 8243) compared to their controls (n = 41,215), resulting in an excess healthcare cost of €5251. Inpatient expenses were the main cost driver and accounted for 31.5% of total incremental costs. Conclusion: The current study showed that CeD patients have considerably higher HCRU and related costs compared to matched controls. Our findings suggest the need for improved treatment options for CeD patients in addition to a gluten-free diet. Plain language summary: Coeliac disease in Germany: costs and care insights from health insurance data Coeliac disease (CeD) is a serious illness where the body reacts to gluten found in food. In Germany, the effects of CeD on patients and the healthcare system are not well-known. We aimed to find out how much healthcare resources and money were used to treat people with CeD in Germany. Health insurance data from 2017 to 2021 were analysed. Out of a population of about 3 million individuals observable in the database, over 8,200 patients with CeD were identified and compared to those without CeD but had similar age, sex, region of residence, and other illnesses. The study revealed that over five years, patients with CeD had more hospital visits and outpatient appointments compared to those without CeD. This led to an extra cost of €5,251 per patient. Most of this cost came from hospital stays. This suggests that better care and treatments are needed for CeD patients beyond just following a gluten-free diet. Improving care for CeD patients might enhance their quality of life and help to reduce healthcare costs in the long run. [ABSTRACT FROM AUTHOR]