Comparing the burden of illness in patients with alopecia areata vs atopic dermatitis in the US population from a payer perspective
Alopecia areata (AA) is an autoimmune disease characterized by nonscarring hair loss. AA frequently co-occurs with other inflammatory autoimmune conditions, presenting a significant clinical burden. To compare the burden of illness, direct and indirect costs in adult patients with AA vs atopic derma...
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| Veröffentlicht in: | Journal of managed care & specialty pharmacy 2023-04, Vol.29 (4), p.409-419 |
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| creator | Fenske, D Christian Ding, Yuxin Morrow, Paula Smith, Sarah G Silver, Monica K Moynihan, Meghan Manjelievskaia, Janna |
| description | Alopecia areata (AA) is an autoimmune disease characterized by nonscarring hair loss. AA frequently co-occurs with other inflammatory autoimmune conditions, presenting a significant clinical burden.
To compare the burden of illness, direct and indirect costs in adult patients with AA vs atopic dermatitis (AD).
This retrospective cohort study used US administrative claims data from the Merative MarketScan Commercial Claims and Encounters Database to compare commercially insured adults with AA to those with AD. Patients with an AA diagnosis between January 2017 and September 2019 were propensity score matched to patients with AD. Comorbidity burden, medication use, health care resource utilization, health care costs, and indirect costs during a 12-month follow-up period were compared between cohorts.
Overall, 25,446 adult patients with AA were selected for the matched analysis with the AD cohort. Patients with AA generally had lower comorbidity burden than patients with AD; mean Deyo-Charlson Comorbidity Index scores were 0.36 (SD = 0.99) and 0.39 (SD = 0.92), for AA and AD, respectively (
= 0.007). Patients with AA had significantly lower proportions of allergic rhinitis, asthma, pruritus, skin infections, and urticaria, but higher proportions of thyroid disease, when compared with patients with AD (all
< 0.001). A smaller proportion of patients with AA had prescriptions for topical (45.3% vs 64.8%;
< 0.001) and oral (20.3% vs 29.6%;
< 0.001) corticosteroids and antianxiety and/or antidepressants (24.7% vs 29.7%;
< 0.001), but a significantly larger proportion for intralesional corticosteroids (triamcinolone) (49.6% vs 21.7%;
< 0.001), compared with patients with AD. Despite a lower comorbidity burden and generally less medication usage in patients with AA, total all-cause health care costs did not significantly differ between the AA and AD cohorts ($10,705 vs $10,816;
= 0.712), and outpatient costs were higher in patients with AA ($6,297 vs $5,859;
= 0.014). Female patients with AA had significantly greater costs for both outpatient and outpatient pharmacy when compared with female patients with AD. Patients with AA were more likely to have a claim for long-term disability (0.6% vs 0.3%;
= 0.001) and higher long-term disability-associated indirect costs ($73 [SD = $1,442] vs $25 [SD = $774];
= 0.004) compared with patients with AD.
We found similar total health care costs in patients with AA and AD, despite a lower proportion of comorbidities and prescript |
| doi_str_mv | 10.18553/jmcp.2023.29.4.409 |
| format | Article |
| fullrecord | <record><control><sourceid>pubmed_cross</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10387998</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>36989453</sourcerecordid><originalsourceid>FETCH-LOGICAL-c406t-f4eb18af1f7485aadb5c8bc8935b91ca81d4f7ffa07934ee94320e8d51bc67ca3</originalsourceid><addsrcrecordid>eNpVkc9OJCEQh4lxo0Z9gk0MLzC90EA3nMxm4u6amHhQz6SaBgfT3RBgZuPZF1_Gf1lPRYr6fRX4EPpOSUOlEOzH02xi05KWNa1qeMOJOkAnLeu7FSWsPXw_E8HJMTrP-YmQOis6SdkROmadkooLdoJe1mGOkPzyiMvG4mGbRrvg4LCfpsXmjP2CIxRvl5LxX182GKYQrfGAIVkogHcZQwnRGzzaNNfR4l9Te9zDHY4hbqfaDQt2KcwYKu7ZJhxtypVT_M6eoW8OpmzP3-spevh1db_-s7q5_X29_nmzMpx0ZeW4HagER13PpQAYB2HkYKRiYlDUgKQjd71zQHrFuLWKs5ZYOQo6mK43wE7R5Rs3bofZjqa-KcGkY_IzpGcdwOuvN4vf6Mew0_VHZa-UrAT2RjAp5Jys-wxTol-96L0XvfeiW6W5rl5q6uL_vZ-ZDwvsH2wVjw8</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Comparing the burden of illness in patients with alopecia areata vs atopic dermatitis in the US population from a payer perspective</title><source>MEDLINE</source><source>PubMed Central</source><creator>Fenske, D Christian ; Ding, Yuxin ; Morrow, Paula ; Smith, Sarah G ; Silver, Monica K ; Moynihan, Meghan ; Manjelievskaia, Janna</creator><creatorcontrib>Fenske, D Christian ; Ding, Yuxin ; Morrow, Paula ; Smith, Sarah G ; Silver, Monica K ; Moynihan, Meghan ; Manjelievskaia, Janna</creatorcontrib><description>Alopecia areata (AA) is an autoimmune disease characterized by nonscarring hair loss. AA frequently co-occurs with other inflammatory autoimmune conditions, presenting a significant clinical burden.
To compare the burden of illness, direct and indirect costs in adult patients with AA vs atopic dermatitis (AD).
This retrospective cohort study used US administrative claims data from the Merative MarketScan Commercial Claims and Encounters Database to compare commercially insured adults with AA to those with AD. Patients with an AA diagnosis between January 2017 and September 2019 were propensity score matched to patients with AD. Comorbidity burden, medication use, health care resource utilization, health care costs, and indirect costs during a 12-month follow-up period were compared between cohorts.
Overall, 25,446 adult patients with AA were selected for the matched analysis with the AD cohort. Patients with AA generally had lower comorbidity burden than patients with AD; mean Deyo-Charlson Comorbidity Index scores were 0.36 (SD = 0.99) and 0.39 (SD = 0.92), for AA and AD, respectively (
= 0.007). Patients with AA had significantly lower proportions of allergic rhinitis, asthma, pruritus, skin infections, and urticaria, but higher proportions of thyroid disease, when compared with patients with AD (all
< 0.001). A smaller proportion of patients with AA had prescriptions for topical (45.3% vs 64.8%;
< 0.001) and oral (20.3% vs 29.6%;
< 0.001) corticosteroids and antianxiety and/or antidepressants (24.7% vs 29.7%;
< 0.001), but a significantly larger proportion for intralesional corticosteroids (triamcinolone) (49.6% vs 21.7%;
< 0.001), compared with patients with AD. Despite a lower comorbidity burden and generally less medication usage in patients with AA, total all-cause health care costs did not significantly differ between the AA and AD cohorts ($10,705 vs $10,816;
= 0.712), and outpatient costs were higher in patients with AA ($6,297 vs $5,859;
= 0.014). Female patients with AA had significantly greater costs for both outpatient and outpatient pharmacy when compared with female patients with AD. Patients with AA were more likely to have a claim for long-term disability (0.6% vs 0.3%;
= 0.001) and higher long-term disability-associated indirect costs ($73 [SD = $1,442] vs $25 [SD = $774];
= 0.004) compared with patients with AD.
We found similar total health care costs in patients with AA and AD, despite a lower proportion of comorbidities and prescription use in patients with AA. Outpatient costs were also significantly higher overall in patients with AA. Although often dismissed as a cosmetic condition, AA, an autoimmune disease, has a similar level of medical expenditure as AD.
This study was funded by Eli Lilly and Company. Mr Fenske and Drs Ding, Morrow, and Smith are employed by Eli Lilly and Company. Drs Manjelievskaia, Moynihan, and Silver are employed by Merative. Drs Manjelievskaia, Moynihan, and Silver were employed by IBM Watson Health at the time of study completion. IBM Watson Health received funding from Eli Lilly and Company to conduct this study.</description><identifier>ISSN: 2376-0540</identifier><identifier>EISSN: 2376-1032</identifier><identifier>DOI: 10.18553/jmcp.2023.29.4.409</identifier><identifier>PMID: 36989453</identifier><language>eng</language><publisher>United States: Academy of Managed Care Pharmacy</publisher><subject>Adrenal Cortex Hormones - therapeutic use ; Adult ; Alopecia Areata - drug therapy ; Alopecia Areata - epidemiology ; Cost of Illness ; Dermatitis, Atopic - drug therapy ; Dermatitis, Atopic - epidemiology ; Female ; Health Care Costs ; Humans ; Retrospective Studies ; Silver - therapeutic use ; United States - epidemiology</subject><ispartof>Journal of managed care & specialty pharmacy, 2023-04, Vol.29 (4), p.409-419</ispartof><rights>Copyright © 2023, Academy of Managed Care Pharmacy. All rights reserved. 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c406t-f4eb18af1f7485aadb5c8bc8935b91ca81d4f7ffa07934ee94320e8d51bc67ca3</citedby><cites>FETCH-LOGICAL-c406t-f4eb18af1f7485aadb5c8bc8935b91ca81d4f7ffa07934ee94320e8d51bc67ca3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10387998/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10387998/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36989453$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fenske, D Christian</creatorcontrib><creatorcontrib>Ding, Yuxin</creatorcontrib><creatorcontrib>Morrow, Paula</creatorcontrib><creatorcontrib>Smith, Sarah G</creatorcontrib><creatorcontrib>Silver, Monica K</creatorcontrib><creatorcontrib>Moynihan, Meghan</creatorcontrib><creatorcontrib>Manjelievskaia, Janna</creatorcontrib><title>Comparing the burden of illness in patients with alopecia areata vs atopic dermatitis in the US population from a payer perspective</title><title>Journal of managed care & specialty pharmacy</title><addtitle>J Manag Care Spec Pharm</addtitle><description>Alopecia areata (AA) is an autoimmune disease characterized by nonscarring hair loss. AA frequently co-occurs with other inflammatory autoimmune conditions, presenting a significant clinical burden.
To compare the burden of illness, direct and indirect costs in adult patients with AA vs atopic dermatitis (AD).
This retrospective cohort study used US administrative claims data from the Merative MarketScan Commercial Claims and Encounters Database to compare commercially insured adults with AA to those with AD. Patients with an AA diagnosis between January 2017 and September 2019 were propensity score matched to patients with AD. Comorbidity burden, medication use, health care resource utilization, health care costs, and indirect costs during a 12-month follow-up period were compared between cohorts.
Overall, 25,446 adult patients with AA were selected for the matched analysis with the AD cohort. Patients with AA generally had lower comorbidity burden than patients with AD; mean Deyo-Charlson Comorbidity Index scores were 0.36 (SD = 0.99) and 0.39 (SD = 0.92), for AA and AD, respectively (
= 0.007). Patients with AA had significantly lower proportions of allergic rhinitis, asthma, pruritus, skin infections, and urticaria, but higher proportions of thyroid disease, when compared with patients with AD (all
< 0.001). A smaller proportion of patients with AA had prescriptions for topical (45.3% vs 64.8%;
< 0.001) and oral (20.3% vs 29.6%;
< 0.001) corticosteroids and antianxiety and/or antidepressants (24.7% vs 29.7%;
< 0.001), but a significantly larger proportion for intralesional corticosteroids (triamcinolone) (49.6% vs 21.7%;
< 0.001), compared with patients with AD. Despite a lower comorbidity burden and generally less medication usage in patients with AA, total all-cause health care costs did not significantly differ between the AA and AD cohorts ($10,705 vs $10,816;
= 0.712), and outpatient costs were higher in patients with AA ($6,297 vs $5,859;
= 0.014). Female patients with AA had significantly greater costs for both outpatient and outpatient pharmacy when compared with female patients with AD. Patients with AA were more likely to have a claim for long-term disability (0.6% vs 0.3%;
= 0.001) and higher long-term disability-associated indirect costs ($73 [SD = $1,442] vs $25 [SD = $774];
= 0.004) compared with patients with AD.
We found similar total health care costs in patients with AA and AD, despite a lower proportion of comorbidities and prescription use in patients with AA. Outpatient costs were also significantly higher overall in patients with AA. Although often dismissed as a cosmetic condition, AA, an autoimmune disease, has a similar level of medical expenditure as AD.
This study was funded by Eli Lilly and Company. Mr Fenske and Drs Ding, Morrow, and Smith are employed by Eli Lilly and Company. Drs Manjelievskaia, Moynihan, and Silver are employed by Merative. Drs Manjelievskaia, Moynihan, and Silver were employed by IBM Watson Health at the time of study completion. IBM Watson Health received funding from Eli Lilly and Company to conduct this study.</description><subject>Adrenal Cortex Hormones - therapeutic use</subject><subject>Adult</subject><subject>Alopecia Areata - drug therapy</subject><subject>Alopecia Areata - epidemiology</subject><subject>Cost of Illness</subject><subject>Dermatitis, Atopic - drug therapy</subject><subject>Dermatitis, Atopic - epidemiology</subject><subject>Female</subject><subject>Health Care Costs</subject><subject>Humans</subject><subject>Retrospective Studies</subject><subject>Silver - therapeutic use</subject><subject>United States - epidemiology</subject><issn>2376-0540</issn><issn>2376-1032</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkc9OJCEQh4lxo0Z9gk0MLzC90EA3nMxm4u6amHhQz6SaBgfT3RBgZuPZF1_Gf1lPRYr6fRX4EPpOSUOlEOzH02xi05KWNa1qeMOJOkAnLeu7FSWsPXw_E8HJMTrP-YmQOis6SdkROmadkooLdoJe1mGOkPzyiMvG4mGbRrvg4LCfpsXmjP2CIxRvl5LxX182GKYQrfGAIVkogHcZQwnRGzzaNNfR4l9Te9zDHY4hbqfaDQt2KcwYKu7ZJhxtypVT_M6eoW8OpmzP3-spevh1db_-s7q5_X29_nmzMpx0ZeW4HagER13PpQAYB2HkYKRiYlDUgKQjd71zQHrFuLWKs5ZYOQo6mK43wE7R5Rs3bofZjqa-KcGkY_IzpGcdwOuvN4vf6Mew0_VHZa-UrAT2RjAp5Jys-wxTol-96L0XvfeiW6W5rl5q6uL_vZ-ZDwvsH2wVjw8</recordid><startdate>202304</startdate><enddate>202304</enddate><creator>Fenske, D Christian</creator><creator>Ding, Yuxin</creator><creator>Morrow, Paula</creator><creator>Smith, Sarah G</creator><creator>Silver, Monica K</creator><creator>Moynihan, Meghan</creator><creator>Manjelievskaia, Janna</creator><general>Academy of Managed Care Pharmacy</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope></search><sort><creationdate>202304</creationdate><title>Comparing the burden of illness in patients with alopecia areata vs atopic dermatitis in the US population from a payer perspective</title><author>Fenske, D Christian ; Ding, Yuxin ; Morrow, Paula ; Smith, Sarah G ; Silver, Monica K ; Moynihan, Meghan ; Manjelievskaia, Janna</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c406t-f4eb18af1f7485aadb5c8bc8935b91ca81d4f7ffa07934ee94320e8d51bc67ca3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adrenal Cortex Hormones - therapeutic use</topic><topic>Adult</topic><topic>Alopecia Areata - drug therapy</topic><topic>Alopecia Areata - epidemiology</topic><topic>Cost of Illness</topic><topic>Dermatitis, Atopic - drug therapy</topic><topic>Dermatitis, Atopic - epidemiology</topic><topic>Female</topic><topic>Health Care Costs</topic><topic>Humans</topic><topic>Retrospective Studies</topic><topic>Silver - therapeutic use</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fenske, D Christian</creatorcontrib><creatorcontrib>Ding, Yuxin</creatorcontrib><creatorcontrib>Morrow, Paula</creatorcontrib><creatorcontrib>Smith, Sarah G</creatorcontrib><creatorcontrib>Silver, Monica K</creatorcontrib><creatorcontrib>Moynihan, Meghan</creatorcontrib><creatorcontrib>Manjelievskaia, Janna</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of managed care & specialty pharmacy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fenske, D Christian</au><au>Ding, Yuxin</au><au>Morrow, Paula</au><au>Smith, Sarah G</au><au>Silver, Monica K</au><au>Moynihan, Meghan</au><au>Manjelievskaia, Janna</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparing the burden of illness in patients with alopecia areata vs atopic dermatitis in the US population from a payer perspective</atitle><jtitle>Journal of managed care & specialty pharmacy</jtitle><addtitle>J Manag Care Spec Pharm</addtitle><date>2023-04</date><risdate>2023</risdate><volume>29</volume><issue>4</issue><spage>409</spage><epage>419</epage><pages>409-419</pages><issn>2376-0540</issn><eissn>2376-1032</eissn><abstract>Alopecia areata (AA) is an autoimmune disease characterized by nonscarring hair loss. AA frequently co-occurs with other inflammatory autoimmune conditions, presenting a significant clinical burden.
To compare the burden of illness, direct and indirect costs in adult patients with AA vs atopic dermatitis (AD).
This retrospective cohort study used US administrative claims data from the Merative MarketScan Commercial Claims and Encounters Database to compare commercially insured adults with AA to those with AD. Patients with an AA diagnosis between January 2017 and September 2019 were propensity score matched to patients with AD. Comorbidity burden, medication use, health care resource utilization, health care costs, and indirect costs during a 12-month follow-up period were compared between cohorts.
Overall, 25,446 adult patients with AA were selected for the matched analysis with the AD cohort. Patients with AA generally had lower comorbidity burden than patients with AD; mean Deyo-Charlson Comorbidity Index scores were 0.36 (SD = 0.99) and 0.39 (SD = 0.92), for AA and AD, respectively (
= 0.007). Patients with AA had significantly lower proportions of allergic rhinitis, asthma, pruritus, skin infections, and urticaria, but higher proportions of thyroid disease, when compared with patients with AD (all
< 0.001). A smaller proportion of patients with AA had prescriptions for topical (45.3% vs 64.8%;
< 0.001) and oral (20.3% vs 29.6%;
< 0.001) corticosteroids and antianxiety and/or antidepressants (24.7% vs 29.7%;
< 0.001), but a significantly larger proportion for intralesional corticosteroids (triamcinolone) (49.6% vs 21.7%;
< 0.001), compared with patients with AD. Despite a lower comorbidity burden and generally less medication usage in patients with AA, total all-cause health care costs did not significantly differ between the AA and AD cohorts ($10,705 vs $10,816;
= 0.712), and outpatient costs were higher in patients with AA ($6,297 vs $5,859;
= 0.014). Female patients with AA had significantly greater costs for both outpatient and outpatient pharmacy when compared with female patients with AD. Patients with AA were more likely to have a claim for long-term disability (0.6% vs 0.3%;
= 0.001) and higher long-term disability-associated indirect costs ($73 [SD = $1,442] vs $25 [SD = $774];
= 0.004) compared with patients with AD.
We found similar total health care costs in patients with AA and AD, despite a lower proportion of comorbidities and prescription use in patients with AA. Outpatient costs were also significantly higher overall in patients with AA. Although often dismissed as a cosmetic condition, AA, an autoimmune disease, has a similar level of medical expenditure as AD.
This study was funded by Eli Lilly and Company. Mr Fenske and Drs Ding, Morrow, and Smith are employed by Eli Lilly and Company. Drs Manjelievskaia, Moynihan, and Silver are employed by Merative. Drs Manjelievskaia, Moynihan, and Silver were employed by IBM Watson Health at the time of study completion. IBM Watson Health received funding from Eli Lilly and Company to conduct this study.</abstract><cop>United States</cop><pub>Academy of Managed Care Pharmacy</pub><pmid>36989453</pmid><doi>10.18553/jmcp.2023.29.4.409</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2376-0540 |
| ispartof | Journal of managed care & specialty pharmacy, 2023-04, Vol.29 (4), p.409-419 |
| issn | 2376-0540 2376-1032 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10387998 |
| source | MEDLINE; PubMed Central |
| subjects | Adrenal Cortex Hormones - therapeutic use Adult Alopecia Areata - drug therapy Alopecia Areata - epidemiology Cost of Illness Dermatitis, Atopic - drug therapy Dermatitis, Atopic - epidemiology Female Health Care Costs Humans Retrospective Studies Silver - therapeutic use United States - epidemiology |
| title | Comparing the burden of illness in patients with alopecia areata vs atopic dermatitis in the US population from a payer perspective |
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