EoE Module 12 References-Dellon Ann Allergy Asthma Immunol 2019 Cost-effective care in eosinophilic esophagitis

Dellon Ann Allergy Asthma Immunol 2019 Cost-effective care in eosinophilic esophagitis

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Eosinophilic esophagitis (EoE) is a chronic, immune-mediated disease with increasing prevalence, affecting approximately 1 in 2000 individuals in the U.S. Its progression often leads to esophageal strictures, necessitating costly treatments like upper endoscopies and medications. This condition incurs substantial costs estimated at $1 billion annually in the U.S., driven by frequent doctor visits, costly pharmacological and dietary treatments, endoscopic monitoring, and complications such as esophageal food bolus impaction.<br /><br />Key challenges include diagnostic delays and the absence of FDA-approved treatments, prompting reliance on expensive off-label therapies such as proton pump inhibitors and topical corticosteroids. Diet-based interventions, although effective, increase food costs, particularly the six-food elimination diet, and are not always covered by insurance. This financial burden, exacerbated by unquantified hidden costs like missed work or school and travel to specialized centers, contributes significantly to patients' and caregivers' stress.<br /><br />Research has evaluated cost-effective care strategies, highlighting the need for streamlined diagnostic and treatment processes. Cost-effective care for EoE should start with a rational diagnostic approach, followed by the assessment of response to singular therapy before considering combination treatments. Long-term maintenance therapy is emphasized to prevent costly complications, alongside effective monitoring methods, potentially reducing reliance on invasive endoscopies through emerging minimally invasive tests.<br /><br />While shared decision-making between patients and providers is advocated to achieve personalized and efficient care, formal analyses on the cost-effectiveness of these methods remain scarce. Future research is needed to optimize cost-effective strategies, including developing non-invasive monitoring techniques and personalized treatment protocols to ensure tailored, cost-efficient management. Progress in these areas, coupled with enhanced disease awareness, can improve patient outcomes and reduce the financial burden associated with EoE.

Keywords

Eosinophilic esophagitis

EoE

esophageal strictures

costly treatments

diagnostic delays

FDA-approved treatments

diet-based interventions

cost-effective care

non-invasive monitoring

personalized treatment