Increased awareness and diagnosis of celiac disease would bring health care costs savings

A study published in Journal of Insurance Medicine by members of the Celiac Disease Center at Columbia University Medical Center has demonstrated an economic benefit to the diagnosis of celiac disease in a national managed-care population in the United States.

Peter HR Green, M.D., Professor of Clinical Medicine and Director, Celiac Disease Center at Columbia University Medical Center, had this to say about the study ( Journal of Insurance Medicine, 2008;40:218-228) and the economic benefits of increased diagnosis of celiac disease: "We now have evidence that the increased awareness and diagnosis of celiac disease would benefit not only the patients but would result in health care costs savings."

Celiac disease occurs in genetically susceptible individuals due to the development of an immune response to gluten, the protein component of wheat, rye and barley. Studies have demonstrated that celiac disease occurs in about 1 percent of the U.S. population; however, most people with this condition remain undiagnosed. Those in whom it is diagnosed have a long duration of symptoms prior to diagnosis. Celiac disease is associated with the development of osteoporosis, anemia, a host of associated autoimmune conditions as well as several different malignancies.

The recent study that examined a large managed-care database revealed reduced health care costs after the diagnosis of celiac disease. The reductions in costs were attributable to decreasing trends in utilization of office visits, laboratory tests, diagnostic imaging and endoscopy procedures in those diagnosed with celiac disease.

As a result of the study, "there needs to be greater physician education in the various modes of presentation and manifestations of celiac disease and more use of the widely available screening blood tests that detect the disease," Dr. Green said.

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