Eosinophilic Esophagitis: Prevalence and Costs in the U.S.

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HL Thel et al. Clin Gastroenterol Hepatol 2025; 23: 272-280. Open Access! Prevalence and Costs of Eosinophilic Esophagitis in the United States

Methods: Using two  large administrative databases, MarketScan and Medicare, the authors estimated  annual prevalence of EoE, as well as age- and sex-stratified estimates, standardized to the U.S. population. Health care utilization, including medications and endoscopic procedures, was quantified, and annual EoE-associated costs were calculated.

Key findings:

  •  There was a 5-fold increase in prevalence in both databases since 2009.
  •  Standardized to the U.S. population, the prevalence of EoE was 142.5/100,000, extrapolating to 472,380 cases. This equates to ~1 in 700 persons.
  • Total EoE-associated annual health care costs were estimated to be $1.32 billion in 2024 dollars after accounting for inflation.
  • PPIs were used more commonly than steroids for treatment. For Marketscan in 2022, PPIs were used in 41% and steroids in 26%.
There has been a 5-fold prevalence increase since 2009
Prevalence by State. Overall, ~1 in 700 EoE Prevalence in U.S.

My take: There is likely a true increase in the number of affected individuals, though some changes in prevalence are due to an increased recognition/testing of eosinophilic esophagitis.

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