The high medical cost of celiac disease missed diagnosis: is it cheaper to suspect it in time?

Although celiac disease (CD) is one of the most common lifelong disorders worldwide, the rate of correct diagnosis is still low. Studies comparing costs of missed CD diagnosis and economical advantages of early CD diagnosis are still lacking. Our aim was to compare the medical cost of a missed CD diagnosis with the minimal expenditure for its correct diagnosis. Twenty-eight patients newly diagnosed with CD were recruited. Accurate medical history of 3 years preceding CD diagnosis was collected. The cost of tests/surveys was acquired from health insurance claims in Italy and USA. Final medical cost was obtained for Italy and USA and compared to the minimal expenditure of a correct CD diagnosis. The mean cost resulted in 135.87 € (Italy) and 2916.00 $ (USA) per each year of delay in CD diagnosis. On the contrary, the ultimate cost of an appropriate diagnosis amounts to only 203.49 € and 2707.00 $. Data show that each year of delay in CD diagnosis is associated with a significant increase in medical care costs. Since CD diagnosis sometimes requires even more than 10 years of medical interventions, its early detection can lead to a considerable saving of both economic and medical resources.