The Prevalence of Eosinophilic Esophagitis in the United States

Background & Aims—Eosinophilic esophagitis (EoE) has become a major cause of upper gastrointestinal morbidity in children and adults. However, there are few data on the nationwide prevalence of EoE. We aimed to estimate the prevalence of EoE in the United States (US). Methods—We collected health insurance claims from a large database that represented the US commercially insured population. We analyzed data from 2008 through 2011, identifying cases of EoE using a previously validated definition, and calculated a period prevalence using data from 2009 through 2011. EoE was defined as any instance of the ICD-9 code 530.13. We calculated the prevalence of the code in the database and standardized the estimate to the US population. Results—Of 35,575,388 individuals in this database, 16,405 had at least 1 code for EoE. The mean age was 33.5 y, 65% were male, 55.8% had dysphagia, and 52.8% had a diagnostic code for at least 1 allergic condition. Among 11,569,217 individuals with continuous insurance coverage between mid-2009 and mid-2011, 6513 had at least one code for EoE. When standardized to the US population, the estimated period prevalence of EoE was 56.7/100,000 persons, translating to © 2013 The American Gastroenterological Association. Published by Elsevier Inc. All rights reserved. Corresponding Author: Evan S. Dellon MD, MPH CB#7080 Bioinformatics Building 130 Mason Farm Rd. UNC-CH Chapel Hill, NC 27599-7080 Phone: (919) 966-2513 Fax: (919) 843-2508 edellon@med.unc. edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Disclosures: None of the authors have competing interests related to this manuscript. Author contributions (all authors approved the final draft): Dellon: Project conception, study design, obtained funding, data interpretation, manuscript drafting, critical revision Jensen: Study design, data analysis, data interpretation, manuscript drafting, critical revision Martin: Data analysis, data interpretation, critical revision Shaheen: Data interpretation, critical revision Kappelman: Study design, data interpretation, critical revision, supervision Note: The statements, findings, conclusions, views and opinions contained and expressed in this article are based in part on data obtained under license from the following IMS Health Incorporated information service: IMS LifeLink® PharMetrics Health Plan Claims Database (January, 2001 through November, 2011), IMS Health Incorporated. All Rights Reserved. The statements, findings, conclusions, views, and opinions contained and expressed herein are not necessarily those of IMS Health Incorporated or any of its affiliated or subsidiary entities. NIH Public Access Author Manuscript Clin Gastroenterol Hepatol. Author manuscript; available in PMC 2015 April 01. Published in final edited form as: Clin Gastroenterol Hepatol. 2014 April ; 12(4): 589–596.e1. doi:10.1016/j.cgh. 2013.09. 008. N IH PA Athor M anscript N IH PA Athor M anscript N IH PA Athor M anscript approximately 152,152 cases in the US. Prevalence peaked in men 35–39 y old, with a rate of 114.6/100,000 persons. Conclusions—Despite its relatively recent description, EoE is frequently diagnosed in the US, with an estimated prevalence of 56.7/100,000 persons. This estimate depends on the accuracy of the ICD-9 code, but could be an underestimate, given that knowledge of the code and recognition of EoE are increasing.