In a study published in the December 2008 issue of the Journal of Insurance Medicine, researchers from Columbia University and CIGNA HealthCare report that diagnosis of celiac disease substantially reduces subsequent health care costs. The research group, led by Peter Green, M.D., at Columbia, looked at medical records for 10.2 million CIGNA managed care members and identified four study cohorts:
- patients with a primary or secondary diagnosis of celiac disease—that is, patients identified with ICD–9 code 579.0, which includes celiac crisis, gluten enteropathy, nontropical sprue, and a few other conditions associated with malabsorption—made in 2000
- patients reporting one primary symptom of celiac disease but not diagnosed with celiac disease during 2000
- patients with two celiac disease symptoms but no diagnosis
- patients with three or more celiac disease symptoms but no diagnosis
The two main findings over the study period were the following:
- The rate of celiac disease diagnosis increased annually during the 4-year study period. Rates of new diagnosis more than doubled over the study period, with rates among women and older adults rising faster than those among men and younger patients.
- Compared with undiagnosed patients with symptoms, those patients diagnosed with celiac disease had lower subsequent medical costs and service utilization rates. The researchers compared annual cost of health care utilization over 12-, 24-, and 36-month periods among the four groups. Those diagnosed with celiac disease had substantially lower health care costs during each follow-up period. Relative economies were greatest when comparing diagnosed patients with those having the greatest number of primary symptoms but no diagnosis.