Quality of Life and societal Costs related to Celiac disease before and after Diagnosis

Abstract

Objectives: – Celiac disease (CD) may affect quality of life (QoL), healthcare use, and societal costs in various ways both before and after diagnosis. However, detailed evidence remains limited about how costs and QoL change after diagnosis, and which patient characteristics (e.g., symptom duration) influence those changes. The aim of this study was to evaluate CD patients’ QoL and societal costs before and after diagnosis.Methods: – In this cross-sectional study, 2, 691 patient-members of the Dutch Celiac Society completed a questionnaire about their life before and after diagnosis. Data collection included: sociodemographic and clinical characteristics, healthcare use, non-healthcare costs, and QoL (measured using the EQ-5D-5L). Mean QoL and annual healthcare and societal costs were compared pre and post-diagnosis. Multivariate regression models were used to identify factors associated with QoL and costs in both periods (and difference between periods).Results: – On average, respondents recalled experiencing 4-5 symptoms before diagnosis. QoL improved significantly post-diagnosis, with greater improvements among childhood diagnoses. Annual healthcare and societal costs decreased by 23% and 36% respectively post-diagnosis, except for societal costs in those diagnosed during childhood. Age at diagnosis and the number of pre-diagnosis symptoms were associated with lower and higher recalled pre-diagnosis QoL, respectively. Number of symptoms, comorbidities, and non-adherence to a GFD were associated lower post-diagnosis QoL.Conclusions: – Following CD diagnosis, QoL significantly improved and healthcare and societal costs decreased, except for societal costs among childhood diagnoses. These findings enhance the understanding of CD’s burden and economic impact, supporting healthcare and policy efforts for timely CD identification.