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The Economics Burden of Atopic Dermatitis

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Management of Atopic Dermatitis

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 1027))

Abstract

Atopic dermatitis (AD) is a chronic inflammatory disorder that affects over 30 million people in the United States of America. Given the large and growing prevalence of AD, the associated economic burden is significant. It has been estimated that AD costs over $5 billion dollars annually. These costs include both direct and indirect costs. Direct costs include prescription medicines, visits to health care providers, hospitalizations, and transportation. Indirect costs include missed days or lost productivity at work or school, career modification, and reduced quality of life. Understanding and measuring these costs can be accomplished through rigorous economic evaluation, which is the organized process of considering inputs and outcomes of various activities. Economic evaluation has been used to contextualize the burden of AD in society. It has also been used to inform patients, providers, and other stakeholders on how to deliver the most evidence-based, efficient care possible. Understanding the economic impact of atopic dermatitis is an important aspect of delivering high quality care.

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References

  1. Thorpe KE, Florence CS, Joski P. Which medical conditions account for the rise in health care spending?. Health Aff (Millwood). 2004; Suppl Web Exclusives:W4-437445.

    Google Scholar 

  2. Dehkharghani S, Bible J, Chen JG, Feldman SR, Fleischer AB Jr. The economic burden of skin disease in the United States. J Am Acad Dermatol. 2003;48(4):592–9.

    Article  PubMed  Google Scholar 

  3. Bickers DR, Lim HW, Margolis D, et al. The burden of skin diseases: 2004 a joint project of the American Academy of Dermatology Association and the Society for Investigative Dermatology. J Am Acad Dermatol. 2006;55(3):490–500.

    Article  PubMed  Google Scholar 

  4. Martin AB, Hartman M, Washington B, Catlin A, National Health Expenditure Accounts T. National health spending: faster growth in 2015 as coverage expands and utilization increases. Health Aff (Millwood). 2017;36(1):166–76.

    Article  Google Scholar 

  5. Hoch JS, Dewa CS. A clinician’s guide to correct cost-effectiveness analysis: think incremental not average. Can J Psychiatry. 2008;53(4):267–74.

    Article  PubMed  Google Scholar 

  6. Pak HS, Datta SK, Triplett CA, Lindquist JH, Grambow SC, Whited JD. Cost minimization analysis of a store-and-forward teledermatology consult system. Telemed J E Health. 2009;15(2):160–5.

    Article  PubMed  Google Scholar 

  7. Chen S, Shaheen A, Garber A. Cost-effectiveness and cost-benefit analysis of using methotrexate vs Goeckerman therapy for psoriasis. A pilot study. Arch Dermatol. 1998;134(12):1602–8.

    Article  CAS  PubMed  Google Scholar 

  8. Schuttelaar ML, Vermeulen KM, Coenraads PJ. Costs and cost-effectiveness analysis of treatment in children with eczema by nurse practitioner vs. dermatologist: results of a randomized, controlled trial and a review of international costs. Br J Dermatol. 2011;165(3):600–11.

    Article  CAS  PubMed  Google Scholar 

  9. Pitt M, Garside R, Stein K. A cost-utility analysis of pimecrolimus vs. topical corticosteroids and emollients for the treatment of mild and moderate atopic eczema. Br J Dermatol. 2006;154(6):1137–46.

    Article  CAS  PubMed  Google Scholar 

  10. Ellis CN, Drake LA, Prendergast MM, et al. Cost-effectiveness analysis of tacrolimus ointment versus high-potency topical corticosteroids in adults with moderate to severe atopic dermatitis. J Am Acad Dermatol. 2003;48(4):553–63.

    Article  PubMed  Google Scholar 

  11. Xu S, Immaneni S, Hazen GB, Silverberg JI, Paller AS, Lio PA. Cost-effectiveness of prophylactic moisturization for atopic dermatitis. JAMA Pediatr. 2017;171(2):e163909.

    Article  PubMed  Google Scholar 

  12. Silverberg JI. Health care utilization, patient costs, and access to care in US adults with eczema: a population-based study. JAMA Dermatol. 2015;151(7):743–52.

    Article  PubMed  Google Scholar 

  13. Parks L, Balkrishnan R, Hamel-Gariepy L, Feldman SR. The importance of skin disease as assessed by “willingness-to-pay”. J Cutan Med Surg. 2003;7(5):369–71.

    Article  PubMed  Google Scholar 

  14. Ellis CN, Drake LA, Prendergast MM, et al. Cost of atopic dermatitis and eczema in the United States. J Am Acad Dermatol. 2002;46(3):361–70.

    Article  PubMed  Google Scholar 

  15. Carroll CL, Balkrishnan R, Feldman SR, Fleischer AB Jr, Manuel JC. The burden of atopic dermatitis: impact on the patient, family, and society. Pediatr Dermatol. 2005;22(3):192–9.

    Article  PubMed  Google Scholar 

  16. Filanovsky MG, Pootongkam S, Tamburro JE, Smith MC, Ganocy SJ, Nedorost ST. The financial and emotional impact of atopic dermatitis on children and their families. J Pediatr. 2016;169:284–290.e5. e285

    Article  PubMed  Google Scholar 

  17. JC S, Kemp AS, Varigos GA, Nolan TM. Atopic eczema: its impact on the family and financial cost. Arch Dis Child. 1997;76(2):159–62.

    Article  Google Scholar 

  18. Handa S, Jain N, Narang T. Cost of care of atopic dermatitis in India. Indian J Dermatol. 2015;60(2):213.

    PubMed  PubMed Central  Google Scholar 

  19. Fivenson D, Arnold RJ, Kaniecki DJ, Cohen JL, Frech F, Finlay AY. The effect of atopic dermatitis on total burden of illness and quality of life on adults and children in a large managed care organization. J Manag Care Pharm. 2002;8(5):333–42.

    PubMed  Google Scholar 

  20. Mancini AJ, Kaulback K, Chamlin SL. The socioeconomic impact of atopic dermatitis in the United States: a systematic review. Pediatr Dermatol. 2008;25(1):1–6.

    Article  PubMed  Google Scholar 

  21. Zuberbier T, Orlow SJ, Paller AS, et al. Patient perspectives on the management of atopic dermatitis. J Allergy Clin Immunol. 2006;118(1):226–32.

    Article  PubMed  Google Scholar 

  22. Holm EA, Esmann S, Jemec GB. The handicap caused by atopic dermatitis—sick leave and job avoidance. J Eur Acad Dermatol Venereol. 2006;20(3):255–9.

    Article  CAS  PubMed  Google Scholar 

  23. Fowler JF, Duh MS, Rovba L, et al. The direct and indirect cost burden of atopic dermatitis: an employer-payer perspective. Manag Care Interface. 2007;20(10):26–32.

    PubMed  Google Scholar 

  24. Brunner PM, Silverberg JI, Guttman-Yassky E, et al. Increasing comorbidities suggest that atopic dermatitis is a systemic disorder. J Invest Dermatol. 2017;137(1):18–25.

    Article  CAS  PubMed  Google Scholar 

  25. Asher MI, Montefort S, Bjorksten B, et al. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC phases one and three repeat multicountry cross-sectional surveys. Lancet. 2006;368(9537):733–43.

    Article  PubMed  Google Scholar 

  26. Karimkhani C, Dellavalle RP, Coffeng LE, et al. Global skin disease morbidity and mortality: an update from the global burden of disease study 2013. JAMA Dermatol. 2017;153:406–12.

    Article  PubMed  Google Scholar 

  27. Simpson EL, Bieber T, Guttman-Yassky E, et al. Two phase 3 trials of dupilumab versus placebo in atopic dermatitis. N Engl J Med. 2016;375(24):2335–48.

    Article  CAS  PubMed  Google Scholar 

  28. Laughter D, Istvan JA, Tofte SJ, Hanifin JM. The prevalence of atopic dermatitis in Oregon schoolchildren. J Am Acad Dermatol. 2000;43(4):649–55.

    Article  CAS  PubMed  Google Scholar 

  29. Shaw TE, Currie GP, Koudelka CW, Simpson EL. Eczema prevalence in the United States: data from the 2003 National Survey of Children’s health. J Invest Dermatol. 2011;131(1):67–73.

    Article  CAS  PubMed  Google Scholar 

  30. Balkrishnan R, Housman TS, Grummer S, et al. The family impact of atopic dermatitis in children: the role of the parent caregiver. Pediatr Dermatol. 2003;20(1):5–10.

    Article  PubMed  Google Scholar 

  31. Lapidus CS, Schwarz DF, Honig PJ. Atopic dermatitis in children: who cares? Who pays? J Am Acad Dermatol. 1993;28(5):699–703.

    Article  CAS  PubMed  Google Scholar 

  32. Lewis-Jones MS, Finlay AY. The Children’s dermatology life quality index (CDLQI): initial validation and practical use. Br J Dermatol. 1995;132(6):942–9.

    Article  CAS  PubMed  Google Scholar 

  33. Holm EA, Wulf HC, Stegmann H, Jemec GB. Life quality assessment among patients with atopic eczema. Br J Dermatol. 2006;154(4):719–25.

    Article  CAS  PubMed  Google Scholar 

  34. Ben-Gashir MA, Seed PT, Hay RJ. Quality of life and disease severity are correlated in children with atopic dermatitis. Br J Dermatol. 2004;150(2):284–90.

    Article  CAS  PubMed  Google Scholar 

  35. Beattie PE, Lewis-Jones MS. A comparative study of impairment of quality of life in children with skin disease and children with other chronic childhood diseases. Br J Dermatol. 2006;155(1):145–51.

    Article  CAS  PubMed  Google Scholar 

  36. Chren MM, Weinstock MA. Conceptual issues in measuring the burden of skin diseases. J Investig Dermatol Symp Proc. 2004;9(2):97–100.

    Article  PubMed  Google Scholar 

  37. Holm EA, Jemec GB. Time spent on treatment of atopic dermatitis: a new method of measuring pediatric morbidity? Pediatr Dermatol. 2004;21(6):623–7.

    Article  PubMed  Google Scholar 

  38. Colten HR, Altevogt BM, Institute of Medicine (U.S.). Committee on Sleep Medicine and Research. Sleep disorders and sleep deprivation : an unmet public health problem. Washington, DC: Institute of Medicine: National Academies Press; 2006.

    Google Scholar 

  39. Nyren M, Lindberg M, Stenberg B, Svensson M, Svensson A, Meding B. Influence of childhood atopic dermatitis on future worklife. Scand J Work Environ Health. 2005;31(6):474–8.

    Article  PubMed  Google Scholar 

  40. Silverberg JI, Simpson EL. Association between severe eczema in children and multiple comorbid conditions and increased healthcare utilization. Pediatr Allergy Immunol. 2013;24(5):476–86.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Suh DC, Sung J, Gause D, Raut M, Huang J, Choi IS. Economic burden of atopic manifestations in patients with atopic dermatitis—analysis of administrative claims. J Manag Care Pharm. 2007;13(9):778–89.

    PubMed  Google Scholar 

  42. Storan ER, McEvoy MT, Wetter DA, et al. Pediatric hospital dermatology: experience with inpatient and consult services at the Mayo Clinic. Pediatr Dermatol. 2013;30(4):433–7.

    Article  PubMed  Google Scholar 

  43. Neri E, Agostini F, Gremigni P, et al. Italian validation of the childhood atopic dermatitis impact scale: a contribution to its clinical application. J Invest Dermatol. 2012;132(11):2534–43.

    Article  CAS  PubMed  Google Scholar 

  44. Emerson RM, Williams HC, Allen BR. What is the cost of atopic dermatitis in preschool children? Br J Dermatol. 2001;144(3):514–22.

    Article  CAS  PubMed  Google Scholar 

  45. Tollefson MM, Bruckner AL, Section On Dermatology. Atopic dermatitis: skin-directed management. Pediatrics. 2014;134(6):e1735–44.

    Article  PubMed  Google Scholar 

  46. Armstrong AW, Johnson MA, Lin S, Maverakis E, Fazel N, Liu FT. Patient-centered, direct-access online care for management of atopic dermatitis: a randomized clinical trial. JAMA Dermatol. 2015;151(2):154–60.

    Article  PubMed  Google Scholar 

  47. Olsen JA, Smith RD. Theory versus practice: a review of ‘willingness-to-pay’ in health and health care. Health Econ. 2001;10(1):39–52.

    Article  CAS  PubMed  Google Scholar 

  48. Cookson R. Willingness to pay methods in health care: a sceptical view. Health Econ. 2003;12(11):891–4.

    Article  PubMed  Google Scholar 

  49. Verboom P, Hakkaart-Van L, Sturkenboom M, De Zeeuw R, Menke H, Rutten F. The cost of atopic dermatitis in the Netherlands: an international comparison. Br J Dermatol. 2002;147(4):716–24.

    Article  CAS  PubMed  Google Scholar 

  50. Foisy M, Boyle RJ, Chalmers JR, Simpson EL, Williams HC. Overview of reviews the prevention of eczema in infants and children: an overview of cochrane and non-cochrane reviews. Evid Based Child Health. 2011;6(5):1322–39.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Horimukai K, Morita K, Narita M, et al. Application of moisturizer to neonates prevents development of atopic dermatitis. J Allergy Clin Immunol. 2014;134(4):824–830.e6. e826

    Article  PubMed  Google Scholar 

  52. Simpson EL, Chalmers JR, Hanifin JM, et al. Emollient enhancement of the skin barrier from birth offers effective atopic dermatitis prevention. J Allergy Clin Immunol. 2014;134(4):818–23.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Gdalevich M, Mimouni D, David M, Mimouni M. Breast-feeding and the onset of atopic dermatitis in childhood: a systematic review and meta-analysis of prospective studies. J Am Acad Dermatol. 2001;45(4):520–7.

    Article  CAS  PubMed  Google Scholar 

  54. Chang YS, Trivedi MK, Jha A, Lin YF, Dimaano L, Garcia-Romero MT. Synbiotics for prevention and treatment of atopic dermatitis: a meta-analysis of randomized clinical trials. JAMA Pediatr. 2016;170(3):236–42.

    Article  PubMed  Google Scholar 

  55. Thaci D, Chambers C, Sidhu M, Dorsch B, Ehlken B, Fuchs S. Twice-weekly treatment with tacrolimus 0.03% ointment in children with atopic dermatitis: clinical efficacy and economic impact over 12 months. J Eur Acad Dermatol Venereol. 2010;24(9):1040–6.

    CAS  PubMed  Google Scholar 

  56. Kesselheim AS, Avorn J, Sarpatwari A. The high cost of prescription drugs in the united states: origins and prospects for reform. JAMA. 2016;316(8):858–71.

    Article  PubMed  Google Scholar 

  57. Ellis CN, Kahler KH, Grueger J, Chang J. Cost effectiveness of management of mild-to-moderate atopic dermatitis with 1% pimecrolimus cream in children and adolescents 2–17 years of age. Am J Clin Dermatol. 2006;7(2):133–9.

    Article  PubMed  Google Scholar 

  58. Garside R, Stein K, Castelnuovo E, et al. The effectiveness and cost-effectiveness of pimecrolimus and tacrolimus for atopic eczema: a systematic review and economic evaluation. Health Technol Assess. 2005;9(29):iii. xi–xiii,1–230

    Article  CAS  Google Scholar 

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Correspondence to Adewole S. Adamson M.D., M.P.P. .

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Adamson, A.S. (2017). The Economics Burden of Atopic Dermatitis. In: Fortson, E., Feldman, S., Strowd, L. (eds) Management of Atopic Dermatitis. Advances in Experimental Medicine and Biology, vol 1027. Springer, Cham. https://doi.org/10.1007/978-3-319-64804-0_8

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