PhD Scientific Days 2024

Budapest, 9-10 July 2024

Poster Session S - Health Sciences 2.

Health State Utilities and Willingness to Pay in Patients with Coeliac Disease


Mária Mercédesz Angyal1, Péter László Lakatos2, Balázs Jenei3, Valentin Péter Brodszky3, Fanni Rencz3
1: Károly Rácz Doctoral School of Clinical Medicine, Semmelweis University
2: Semmelweis University 1st Department of Medicine, Budapest, Hungary and McGill University Health Centre, Division of Gastroenterology, Montreal, QC, Canada
3: Corvinus University of Budapest, Department of Health Policy, Budapest, Hungary

Text of the abstract

Introduction: Coeliac disease (CD) is a life-long food-related disorder with a global prevalence of approximately 1%. Patients with CD often experience reduced health-related quality of life that could improve with a strict adherence to a gluten-free diet (GFD).
Aims: This study aims to assess health utilities and willingness to pay (WTP) among patients with CD and to determine the potential impact of GFD on these health outcomes.
Methods: In 2020-21, a cross-sectional online survey was carried out among CD patients aged 18 years or over through relevant social media sites in Hungary. Patients were asked to evaluate their current health and three hypothetical health states defined based on dietary adherence using visual analogue scale (VAS), 10-year time trade-off (TTO) and WTP. The Gastrointestinal Symptom Rating Scale (GSRS) was used to assess gastrointestinal complaints. Determinants of VAS, TTO and WTP values were analyzed using multivariate regressions.
Results: Responses of 312 CD patients following a GFD were analyzed (mean±SD age 35.8±11.5 years and 70.2% female. Mean VAS utilities for current health, ‘CD with strict adherence to GFD’, ‘CD with loose adherence to GFD’ and ‘CD without GFD’ hypothetical health states were 0.80±0.19, 0.85±0.16, 0.62±0.20 and 0.37±0.26, respectively. Mean TTO utilities were higher, than VAS: 0.90±0.19, 0.91±0.20, 0.87±0.23 and 0.76±0.29, and mean annual WTP values for returning to full health were as follows: 845±1077, 648±1002, 862±1135 and 1251±1496 euro. Patients with more severe gastrointestinal symptoms (GSRS) provided lower VAS and TTO utilities, and higher WTP values (p<0.05). Women were willing to trade less life-years in the TTO and pay less in order to regain full health (p<0.05). Older age at diagnosis was associated with lower VAS and higher WTP values (p<0.05) in a linear regression model.
Conclusion: This study provides a better understanding of the burden of CD and its impact on patients’ health-related quality of life. Strict adherence to the GFD may result in substantial health gains. Utilities and WTP results from this study can be used to estimate benefits of GFD in cost-utility and cost-benefit analyses.
Funding: First author's work has been supported by the New National Excellence Program 2020 of the Ministry of Innovation and Technology (ÚNKP-20-2-I-CORVINUS-27).