Abstract
Background and Aims:
Eosinophilic esophagitis (EoE) has been continually increasing in prevalence but current estimates are lacking. We aimed to determine updated estimates of the prevalence and medical costs associated with EoE in the United States.
Methods:
We used two large administrative databases, MarketScan and Medicare, and International Classification of Disease codes to calculate annual prevalence of EoE, as well as age- and sex- stratified estimates, standardized to the U.S. population. Health care utilization, including medications and endoscopic procedures was quantified, and annual EoE-associated costs were estimated.
Results:
We identified 20,435 EoE cases in MarketScan in 2022 and 1,913 EoE cases in Medicare in 2017. This translated to prevalences of 163.08 cases/100,000 and 64.83 cases/100,000 in MarketScan and Medicare, respectively. There was a 5-fold increase in prevalence in both databases since 2009. In MarketScan, prevalence was higher among males (204.45/100,000 vs 122.06/100,000 among females); for both sexes, peak prevalence was from 40–44years. Standardized to the U.S. population, the prevalence of EoE was 142.5/100,000, extrapolating to 472,380 cases. Total EoE-associated healthcare costs were estimated to be $1.32 billion in 2024 dollars after accounting for inflation.
Conclusions:
The prevalence of EoE continues to increase, with a rate of 1 in 617 in 2022 in those <65 years of age, and 1 in 1562 in 2017 those ≥65 years. Standardized to the U.S. population, the overall prevalence was approximately 1 in 700. EoE-associated annual costs were estimated to be $1.3 billion in 2024 dollars, representing a substantial financial burden.
Keywords: eosinophilic esophagitis, prevalence, costs, administrative claims, MarketScan, Medicare
Graphical Abstact
Introduction
Eosinophilic esophagitis (EoE) is a chronic allergic disease, characterized by abnormal eosinophilic infiltration of the esophagus (≥ 15 peak eosinophils/ high powered field) leading to symptoms of esophageal dysfunction, in the absence of other causes of esophageal eosinophilia.1 Only recognized over the past three decades, EoE was once considered a rare condition.2,3 However, over the past two decades, incidence rates and prevalence have rapidly increased, making it a common cause of upper gastrointestinal morbidity.4 Most likely, the rapidly evolving epidemiology of EoE reflects environmental rather than genetic factors, with a number of candidate risk factors and early life exposures identified.5
A recent meta-analysis estimated the global pooled prevalence of EoE to be 40.04 cases per 100,000 inhabitant-years, with an estimated pooled prevalence of 55.41 cases per 100,000 inhabitant-years in the United States.6 However, there is heterogeneity in these estimates. While some estimates are population-based, many are reliant on the centers where the studies were conducted and may not fully reflect the most updated prevalence, particularly in the U.S. where the most recently reported estimates are more than a decade old.7 The data related to costs and disease burden of EoE are equally out of date. While past studies investigating EoE-associated heath care costs estimated annual health costs of as much as $1.4 billion,8, 9 these estimates were based on data from 2009–2010, and only included individuals under age 65. Thus, they do not account for increased prevalence over the past decade or the burden of disease in the age ≥65 population.
The aim of this study was to determine updated estimates of the prevalence and medical costs associated with EoE in the United States using two large administrative databases. We hypothesized that we would observe year-over-year increases in EoE prevalence as well as higher costs than previously reported.
Methods
Data Sources and Study Design
Our data sources were two national insurance claims databases: Merative MarketScan Commercial Claims and Encounters database (©2022 Merative; All Rights Reserved), and a 20% random sample of nationwide Medicare Fee-for-Service (Parts A and B) insurance enrollment and claims. Medicare Advantage plans were not included.
Merative MarketScan is a compiled dataset of de-identified individual patient healthcare data from >240 million individuals with commercial insurance plans from 1995 and forward. It includes insurance enrollment information, in addition to inpatient, outpatient, and prescription drug claims. Data are obtained through employers, states, hospitals and electronic medical records (EMRs).10 Medicare administrative data includes health services utilization data, collected by the Centers for Medicare and Medicaid Services (CMS) annually and derived from reimbursement information or payment of bills.11 Medicare beneficiaries include individuals over the age of 65 in addition to those with disability, end stage renal disease, and amyotrophic lateral sclerosis.12
Using these databases, we conducted a retrospective study using cross-sectional data to estimate the prevalence, treatment utilization, and direct medical costs associated with eosinophilic esophagitis-associated encounters from 2009–2022 for MarketScan and 2009–2017 for Medicare, the years of data to which we have access and that are after the introduction of the EoE billing code in 2008. We included patients aged <65 years in the MarketScan commercial claims database and patients aged ≥65 years in the Medicare enrollment and claims database. We excluded patients aged ≥65 years in MarketScan database, as this only includes a small subset of patients who have supplemental commercial insurance, has missing data for the age group, and to prevent duplication of patients between databases (as it is not possible to distinguish which individuals are included in both databases). However, we performed a supplemental analyis of patients aged ≥65 in the MarketScan Medicare-eligible files from 2017–2022, which contain data from those with employer-sponsored Medicare Supplemental and Medicare Advantage plans.
All analyses were performed using SAS 9.4. This study was deemed to be exempt from ongoing review by the UNC Institutional Review Board.
Case Definitions and Prevalence Calculations
Annual prevalence was calculated using well-established methodology for estimating prevalence in administrative claims databases.13,14 We used the proportion of enrollees with continuous enrollment in the calendar year as the denominator population. Our primary EoE case definition required having at least one claim with an International Classification of Diseases (ICD)-Ninth Revision-Clinical Modification (ICD-9) or ICD-Tenth Revision-Clinical Modification (ICD-10) diagnosis code for EoE (ICD-9 530.13; ICD-10 K20.0) in any healthcare setting (inpatient or outpatient), at any diagnosis position, in a given year.7,15 We performed a sensitivity analysis for a secondary case definition which required at least two claims on different days with an ICD-9 or ICD-10 diagnosis code for EoE in a given year. An individual was counted as prevalent within any calendar year in which they had an EoE diagnosis, and a person could appear as a prevalent case in multiple years.
Prevalence was reported per 100,000 persons for each year (January 1 through December 31) for which we had data. It was also calculated separately in groups by age and sex. Age groups for MarketScan were <5, 5–9, 10–14, 15–19, 20–24, 25–29, 30–34, 35–39, 40–44, 50–54, 55–59, and 60–64. Age groups for Medicare were 65–69, 70–74, 75–79, 80–84, and 85+.
We standardized prevalence from the two administrative databases to the United States population. To do this, we applied the most recent prevalence estimates (2022 for MarketScan and 2017 for Medicare), stratified by age and sex, to the corresponding U.S. population distribution, stratified by age and sex, using 2020 U.S. census data.16
Utilization and Costs
A list of CPT codes related to EoE treatment was generated to reflect EoE-associated symptoms, complications, comorbidities, and endoscopies (Supplementary Table 1). NDC codes for prescription medications were identified using the US Food and Drug Administration National Drug Code directory.17 To measure utilization, we calculated the proportion of prevalent cases within a given year who had at least one CPT code or NDC code for the respective treatment over the total number of prevalent EoE cases within that year.
Direct annual medical costs associated with EoE in 2017 were calculated based on 36 age- sex strata. We calculated costs in 2017, as this was the most recent year with available data in both databases. We first calculated the sum of costs of insurance claims (inpatient, outpatient, and prescription medications) where EoE was listed as first or second diagnosis code. These calculations were done in 2017 US dollars. We then calculated the calendar-year mean cost by dividing total cost by total number of cases in each stratum. Estimated annual EoE cases were calculated by multiplying point-prevalence of each age-sex (2022 prevalence for MarketScan, 2017 for Medicare) by the 2020 census population in each stratum.16 We then multiplied calendar- year mean costs per period prevalent case by the estimated total number of EoE cases in each age-sex stratum to calculate the total national annual medical costs in 2017 associated with EoE. In order to estimate the total costs in 2024 dollars, we applied a 26.6% rate of inflation.24
Results
Characteristics of Eosinophilic Esophagitis Cases
In 2022, 20,435 patients met our primary EoE case definition in the MarketScan database. The mean age was 38.1 years, 16% were under the age of 18, 62% were male, and 41% had a comorbid allergic disease code within 2022 (Table 1). There were a mean of 2.2±4.7 EoE claims per person (median 1; interquartile range [IQR] 1–3). The most common symptoms and diagnoses were dysphagia, abdominal pain/dyspepsia, and esophageal strictures, reported in 39%, 24%, and 19% of patients, respectively within 2022. When we assessed if patients in 2022 ever had a code for a comorbid allergic disease, dysphagia, esophageal foreign body, or esophageal stricture, the proportions were 64%, 62%, 12%, and 32%, respectively (Supplemental Table 2).
Table 1.
Characteristics of EoE patients in the same year as the index diagnosis in the MarketScan and Medicare databases
| MarketScan | Medicare | ||||
|---|---|---|---|---|---|
|
| |||||
| 2009 (N = 5,284) | 2016 (N = 16,977) | 2022 (N = 20,435) | 2009 (N = 279) | 2017 (N = 1913) | |
|
|
|||||
| Age (mean ± SD, range) | 32.2 ± 17.5 (0.3–64.8) | 36.5 ± 16.8 (0.2–65.0) | 38.1 ± 16.4 (0.6–65.0) | 74.4 ± 6.7 (65.0–97.0) | 72.9 ± 5.9) (65.0–104) |
| Median age (IQR) | 34.5 (16.4–46.8) | 39.0 (21.8–50.6) | 40.5 (24.2–51.7) | 72.7 (68.8–78.9) | 71.5 (68.4–76.2) |
| < 18 years old (n, %) | 1515 (29) | 3340 (20) | 3231 (16) | -- | -- |
| Male (n, %) | 3539 (67) | 10681 (63) | 12663 (62) | 130 (47) | 893 (47) |
| Race (n, %) | |||||
| White | -- | -- | -- | 254 (91) | 1713 (90) |
| Black | -- | -- | -- | <11* | 81 (4) |
| Asian | -- | -- | -- | <11* | 16 (1) |
| Hispanic | -- | -- | -- | <11* | 21 (1) |
| North America Native/ Other | -- | -- | -- | <11* | 36 (2) |
| Unknown | -- | -- | -- | 0 (0) | 46 (2) |
| Number of EoE claims per person (mean ± SD, range) | 1.7 ± 1.6 (1–36) | 2.3 ± 5.8 (1–364) | 2.2 ± 4.7 (1–358) | 1.6 ± 1.1 (1–10) | 2.0 ± 1.7 (1–20) |
| Median claims (IQR) | 1 (1–2) | 1 (1–2) | 1 (1–3) | 1 (1–2) | 1 (1–2) |
| Symptom or diagnosis (n, %) | |||||
| Dysphagia | 2583 (49) | 7686 (45) | 7937 (39) | 151 (54) | 928 (49) |
| Esophageal foreign body | 554 (10) | 1223 (7) | 1040 (5) | 13 (5) | 80 (4) |
| Esophageal stricture | 1210 (23) | 3689 (22) | 3948 (19) | 93 (33) | 579 (30) |
| Esophageal perforation | 22 (0) | 33 (0) | 34 (0) | 0 (0) | <11* |
| Abdominal pain/dyspepsia | 1749 (33) | 4838 (28) | 4998 (24) | 133(48) | 671 (35) |
| Heartburn | 276 (5) | 1170 (7) | 1119 (5) | 18 (6) | 147 (8) |
| Pain in chest or throat | 717 (14) | 2233 (13) | 2407 (12) | 105 (38) | 515 (27) |
| Nausea or vomiting | 784 (15) | 1947 (11) | 2090 (10) | 52 (19) | 230 (12) |
| Failure to thrive | 153 (3) | 299 (2) | 307 (2) | <11* | 26 (1) |
| Allergic diseases (n, %) | |||||
| Any allergic disease | 2016 (38) | 7432 (44) | 8401 (41) | 96(34) | 690 (36) |
| Rhinitis | 1195 (23) | 4972 (29) | 5277 (26) | 65(23) | 401 (21) |
| Sinusitis | 316 (6) | 943 (6) | 856 (4) | 25 (9) | 147 (8) |
| Dermatitis | 175 (3) | 478 (3) | 813 (4) | <11* | 34 (2) |
| Urticaria | 59 (1) | 314 (2) | 439 (2) | <11* | 21 (1) |
| Asthma | 937 (18) | 3310 (19) | 3932 (19) | 44 (16) | 337 (18) |
| Food allergies | 166 (3) | 1664 (10) | 1634 (8) | <11* | 54 (3) |
| Medications (n, %) | |||||
| Proton pump inhibitors | 1771 (34) | 4882 (29) | 8421 (41) | 91 (33) | 612 (32) |
| Topical steroids | 2092 (40) | 3739 (22) | 4108 (20) | 45(16) | 168 (9) |
| Allergy medications** | 2 (0) | 942 (6) | 1796 (9) | <11* | 102 (5) |
| Immunomodulators | 16 (0) | 143 (1) | 172 (1) | <11* | 23 (1) |
| Biologics | 7 (0) | 45 (0) | 681 (3) | 0 (0) | 0 (0) |
| Endoscopy and radiologic testing (n, %) | |||||
| Upper endoscopy, diagnostic | 542 (10) | 1163 (7) | 934 (5) | 27(10) | 137(7) |
| Upper endoscopy with biopsy | 4295 (81) | 11058 (65) | 11491 (56) | 228 (82) | 1324(69) |
| Upper endoscopy with dilation (guidewire) | 450 (9) | 1319 (8) | 1288 (6) | 32 (11) | 198(10) |
| Upper endoscopy with dilation (balloon) | 539 (10) | 1556 (9) | 1885 (9) | 31 (11) | 240 (13) |
| Upper endoscopy with injection | 10 (0) | 38 (0) | 34 (0) | <11* | 14 (1) |
| Upper endoscopy with stent placement | 0 (0) | 2 (0) | 9 (0) | 0 (0) | 0 (0) |
| Upper endoscopy with placement of catheter or feeding tube | 20 (0) | 30 (0) | 20 (0) | <11* | 21 (1) |
| Transnasal endoscopy | 0 (0) | 16 (0) | 37 (0) | 0 (0) | <11* |
| Barium esophagram | 456 (9) | 889 (5) | 608 (3) | 36(13) | 153 (8) |
|
| |||||
Per CMS policy, no cell sizes <11 may be reported and percentages cannot be calculated for cells sizes <11
montelukast, zafirlukast, cromolyn, ketotifen
In 2017, 1913 patients met our primary EoE definition in the Medicare database. The mean age was 72.9 years, 47% were male, 90% were non-Hispanic white, and 36% of patients had a comorbid allergic disease, with a mean of 2.9±3.6 EoE claims per person. The most common symptoms and diagnoses within 2017 were dysphagia, abdominal pain/dyspepsia, and esophageal stricture, reported in 49%, 35%, and 30% of patients, respectively (Table 1), and these were also higher when we assessed if the codes were ever present over a given patient’s total time in the claims data (Supplemental Table 2).
Prevalence
The prevalence of eosinophilic esophagitis using our primary definition in MarketScan was 163.08 cases/100,000 people in 2022. Prevalence increased annually from 2009 (28.26/100,000) to 2022, with the exception of 2020, presumably related to the pandemic (Figure 1). Prevalence was higher among males, with 204.45 cases/100,000 people compared to 122.06 cases/100,000 people among females in 2022. For both sexes, peak prevalence was in the 40–44year age range, with a decrease in prevalence after age 45 (Figure 2A–C; Supplemental Figure 1 shows annual increases stratified by age and sex). There was variability in prevalence by state (Figure 3). For example, prevalence was highest in Idaho (291.26/100,000) and lowest in New Mexico (68.16/100,000); prevalence was intermediate in North Carolina (149.72/100,000) and Illinois (179.04/100,000).
Figure 1.
Eosinophilic esophagitis prevalence among MarketScan and Medicare patients over time. The solid black line with circles indicates overall eosinophilic esophagitis prevalence among MarketScan patients between 2009 and 2022 using the primary case definition (one code). The dotted black line with squares indicates overall eosinophilic esophagitis prevalence among Medicare patients between 2009 and 2017 using the primary case definition (one code).
Figure 2.
Eosinophilic esophagitis prevalence across sex and age groups at three points in time in MarketScan patients in (A) 2009, (B) 2015, and (C) 2022 (C) using the primary case definition (one code). Eosinophilic esophagitis prevalence across sex and age groups among Medicare patients in (D) 2009, (E) 2013, and (F) 2017 using the primary case definition (one code).
Figure 3.
Eosinophilic esophagitis prevalence across the United States, using the primary case definition (one code) in MarketScan for 2022, with the exception of Vermont and Delaware, where 2021 prevalence estimates were used.
In Medicare, the prevalence of EoE using our primary definition was 64.83 cases/100,000 people in 2017. Annual prevalence increased every year from 2009, when prevalence was 12.37 cases/100,000 people (Figure 1). Prevalence was higher among males, with 79.24 cases/100,000 people in 2017, compared to 55.21 cases/ 100,000 people among females (Figure 2D–F; Supplemental Figure 2 shows annual increases stratified by age and sex). Prevalence was highest among the 65–69 year age range among both sexes and decreased with increasing age. Prevalence was 74.74/100,000 in 2022 in the Medicare-eligible MarketScan dataset (Supplemental Table 3).
When the most recently available annual prevalences were standardized to the U.S. population based on age and sex and using the primary case definition, the rate was 142.5 cases/100,000 people, or approximately 1 in 700. This extrapolated to 472,380 cases in the U.S.
On sensitivity analysis applying the case definition requiring two codes, the prevalence in Marketscan in 2022 was 75.92/100,000 and in Medicare in 2017 was 28.51/100,000; these prevalences had also steadily increased since 2009 (Supplemental Figure 3). When standardized to the U.S. population, the prevalence with two EoE codes was 67.1/100,000. Similar trends in prevalence for sex was seen on sensitivity analysis (Supplemental Figure 4) as were seen with the primary coding definition. When comparing age groups on sensitivity analysis, there were two peaks in prevalence, one in the 15–19 year-old age range, and the other in the 40–44 year age range (seen on primary analysis) (Supplemental Figure 4).
Utilization and Costs
The utilization of endoscopy with dilation or biopsy in EoE patients was approximately 60–70% in both MarketScan and Medicare within the examined years (Table 1). When assessing ever having a procedure in the databases, upper endoscopy with biopsy was coded in 80–90% of patients, guidewire-based dilation in 11–17%, and ballon-based dilation in 13–20% (Supplemental Table 2). The utilization of other procedural treatments such as endoscopy with injection, stent, catheter placement, transnasal endoscopy, and barium esophagram were low in both cohorts. In terms of prescription medications, PPIs and topical steroids were the most common, with 41% and 26%, respectively, in MarketScan in 2022, and 32% and 9%, respectively, in Medicare in 2017 (Table 1). These proportions were higher for ever use of the medications (Supplemental Table 2).
The total EoE-associated healthcare costs were $1.04 billion in 2017 dollars. When assessing age-sex strata, among males, the age cohort with the highest associated costs was 10–14 years, estimated to be $106.73 million. Among females, the age cohort with the highest associated costs was 15–19 years, estimated to be $46.52 million. The cohort with the lowest associated costs was 85+ years for both males and females, estimated to be $474,558.02 and $417,622.33, respectively. When adjusting for inflation, total EoE-associated costs in 2024 dollars were $1.32 billion.
Discussion
The prevalence of eosinophilic esophagitis has rapidly increased in the past two decades. Given this rapid change, existing prevalence estimates from large datasets representative of the U.S. population are likely out of date. Using two national insurance claims databases, we found that in 2022, the prevalence of EoE was 163.1 cases/ 100,000 people in MarketScan and 64.4 cases/ 100,000 people in Medicare, in 2017. Both of these estimates represent a 5-fold increase from 2009, and we observed the prevalence increase in all age strata and for both sexes. When we standardized these data to the U.S. population, we found an overall prevalence of 142.5 cases/ 100,000 people, or approximately 1 in 700. These findings suggest that EoE is no longer a rare condition and represents an increasingly common cause of GI morbidity. The impact of EoE on the healthcare system is substantial, with estimated associated costs of over $1.3 billion in 2024.
This study utilized a methodology relatively similar to that in our prior work which estimated EoE prevalence 2009–2011, and found a 2-year period prevalence of 56.3 cases/100,000 people.7 Since then, several studies that utilized large national claims databases have estimated that overall prevalence of EoE ranges between 25.9–78.8/100,000.18–21 It is difficult to directly compare these values to our estimates, as we calculated 1-year point prevalences over many years, whereas some of these studies calculated cumulative prevalence over multiple years, and some used population-based survey methodology.22 Overall, our estimates show a continually increasing prevalence trend, with the highest yet reported rates and with a slight increase in the age of peak prevalence, which could suggest a cohort effect. Increases in EoE prevalence have been observed globally, for example, in Japan, a recent study reported a 10-fold increase in prevalence between 2010 and 2022,23 and such increases help to support changing environmental factors as etiologic,5 though within the scope of this study we cannot hypothesize as to specific causes.
In regard to healthcare costs, we estimated that annual expenditure associated with EoE is $1.04 billion in 2017 dollars but calculated with 2022 prevalence in MarketScan and 2017 prevalence in Medicare. If we adjust for inflation from 2017 to 2024,24 our estimate increases to $1.32 billion. This is still likely an underestimate of costs, give that prevalence likely increased among those older than 65 since 2017, and for all between 2022 and 2024. In 2015, a study by Jensen and colleagues estimated that annual healthcare costs in patients with EoE ranged from $503 million to $1.36 billion/year depending on the case definition used.8 Because that study included emergency department costs as well as all costs in EoE patients (regardless of the EoE claim position), our study used costs for claims where the EoE was in only the first or second position, thus the two values cannot be directly compared. Increases in total costs for EoE patients have been observed globally, including in a Swedish study which attributed increasing costs to increases in prevalence, given stable costs-per-patient.25 The high costs are likely driven in part by endoscopy utilization. For example, in 2022 the proportion of EoE patients in MarketScan who underwent upper endoscopy, upper endoscopy with biopsy, and upper endoscopy with dilation were 5%, 56% and 15%, respectively. In 2017, these proportions in Medicare were 7%, 69% and 23%, respectively. This would be consistent with guidelines for diagnosis and monitoring of EoE, and emphasizes the substantial burden of the disease on patients.26,27
A key consideration regarding our prevalence estimates is our case definition. We defined a case as an individual with at least one claim with an ICD-9 or ICD-10 diagnosis code for EoE. This method has previously been validated and found to have a lower sensitivity and near-perfect specificity of 99%.15 However, this was at a time when the ICD codes for EoE were new and may have had a low uptake, and we would hypothesize the sensitivity would be higher but the specificity lower if this validation were updated. While this could raise the question of misclassification and overestimation of prevalence with our primary coding definition, we are reassured that the characteristics, symptom codes, and procedure codes are concordant with what we would expect for cases of EoE. Our primary case definition identified a predominately male and younger population, with fairly frequent reports of dysphagia and comorbid allergic diseases, particularly when we looked for ever having codes. Further, to address concerns for misclassification, we performed a sensitivity analysis using a definition of EoE requiring at least two claims with an ICD-9 or ICD-10 diagnosis code for EoE in a given year. This more conservative secondary definition represents a lower bound of prevalence estimates, which is approximately half as high as the upper bound.
In addition to a degree of uncertainty regarding case definitions in large claims databases, this study had other limitations. Administrative claims data provide limited granular clinical and demographic information about individuals, such as disease severity, race, and ethnicity. These data sources also do not contain endoscopy reports, indications, or biopsy findings. We also had limitations regarding the data we were able to access and were only able to calculate prevalence estimates up to 2017 in the Medicare database. Additionally, our study excluded those with Medicaid or no insurance, so we may be underestimating the true prevalence.28 Our results are most representative of those with commercial insurance and the older population with fee-for-service Medicare. Including these populations in future prevalence studies may provide a more comprehensive estimate for the U.S. population. Strengths of this study include the use of two large, national administrative databases, that allow us to providing prevalence estimates in a large proportion of the U.S. population. The inclusion of the Medicare database provided prevalence estimates in the 65+ year old population, which has previously not been reported.
In conclusion, the prevalence of EoE in the MarketScan database among those under 65 was 1 in 617 in 2022, and was 1 in 1562 among those older than 65 in 2017 in the Medicare data. Standardized to the U.S. population, we calculated a prevalence of 142.5 cases/100,000, which is approximately 1 in 700. EoE was associated with substantial financial burden on the U.S. healthcare system, with an estimated EoE-associated annual cost of over $1.3 billion in 2024 dollars. Given the dramatic 5-fold rise in prevalence since 2009, EoE is now a commonly encountered condition representing a significant burden of disease, and should be considered in patients with upper gastrointestinal symptoms.
Supplementary Material
What you need to know:
BACKGROUND:
Eosinophilic esophagitis (EoE), has been considered a rare disease, but the prevalence of this chronic condition has been increasing over the past two decades. Current estimates of EoE prevalence are lacking.
FINDINGS:
The prevalence of EoE has increased 5-fold since 2009. Standardized to the U.S., the prevalence rate is 142.5 cases/100,000, or approximately 1 in 700 people. Total EoE-associated health care costs were estimated to be $1.32 billion dollars.
IMPLICATIONS FOR PATIENT CARE:
EoE continues to have a markedly increasing prevalence, with an associated substantial healthcare burden. Providers should expect to commonly encounter EoE in clinical settings.
Funding:
This study was supported by NIH T35 DK007386 and used resources from the UNC Center for GI Biology and Disease (P30 DK034987)
Disclosures:
ESD reports research funding from Adare/Ellodi, Allakos, Arena/Pfizer, AstraZeneca, Eupraxia, Ferring, GSK, Meritage, Miraca, Nutricia, Celgene/Receptos/BMS, Regeneron, Revolo, Shire/Takeda; consulting fees from Abbott, Abbvie, Adare/Ellodi, Aimmune, Akesobio, Alfasigma, ALK, Allakos, Amgen, Apollo, Aqilion, Arena/Pfizer, Aslan, AstraZeneca, Avir, Biorasi, Bryn, Calypso, Celgene/Receptos/BMS, Celldex, Eli Lilly, EsoCap, Eupraxia, Dr. Falk Pharma, Ferring, GSK, Gossamer Bio, Holoclara, Invea, Knightpoint, Landos, LucidDx, Morphic, Nexstone Immunology/Uniquity, Nutricia, Parexel/Calyx, Phathom, Regeneron, Revolo, Robarts/Alimentiv, Salix, Sanofi, Shire/Takeda, Target RWE, Upstream Bio; and educational grants from Allakos, Aqilion, Holoclara, Invea.
ETJ reports research funding from TARGET-RWE and consulting fees from Regeneron, Jazz Pharmaceuticals, and TARGET-RWE. ETJ has also received honorarium from AAAAI, AGA, and ADA and travel funds from AAAAI, ADA, and Lausanne University Hospital. None of other authors report any potential conflicts of interest
Footnotes
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