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Quality of Life and Costs in Atopic Dermatitis

  • R. J. G. Arnold
  • R. K. Kuan
Reference work entry

Abstract:

Patients with atopic dermatitis ( AD) experience considerable burden due to the disease. This burden is multidimensional and impacts health-related quality of life (HRQOL), finances and treatment choices. A lower quality of life ( QOL) results from decreased social functioning, worse mental health, anxiety and stress, increased incidence of psychiatric disorders, behavioral problems and sleep loss. The burden of AD reaches beyond the patient and extends to caretakers and parents of children with AD, families of patients with AD, and partners of adults with AD. However, while AD has been shown to negatively impact HRQOL of both patients and their caregivers, there is evidence that effective treatment, specifically  immunomodulators, can significantly improve HRQOL.

In addition to its considerable impact on patient QOL, the monetary burden of AD is substantial. Studies have demonstrated  direct costs ranging from US $150 to 580 per patient per year, with the range of costs being reported due to different  cost-accounting methods. Typically, outpatient visits and medications comprised the majority of direct costs and costs tended to increase with increasing severity of AD.

There have been several studies comparing cost and cost-effectiveness of different uses of topical corticosteroids ( TCS) and of topical immunomodulators such as pimecrolimus and tacrolimus. In comparisons between once-daily and twice-daily applications of TCS, it remains debatable which regimen is more cost-effective. Studies have generally shown immunomodulators to be cost-effective versus TCS.

Keywords

Atopic Dermatitis Mometasone Furoate Severe Atopic Dermatitis Tacrolimus Ointment Moderate Atopic Dermatitis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

List of Abbreviations:

AD

atopic dermatitis

AWP

average wholesale price

CADIS

childhood atopic dermatitis impact scale

CEACs

cost-effectiveness acceptability curves

CDLQI

children’s dermatology life quality index

DCD

disease controlled days

DFI

dermatitis family impact score

DLQI

dermatology life quality index

DSQL

dermatology-specific quality of life

FDLQI

family dermatology life quality index

HPTC

high potency topical corticosteroids

HRQOL

health-related quality of life

ICER

incremental cost-effectiveness ratio

IDQOL

infant’s dermatology quality of life index

IGA

investigator’s global assessment

ISDL

impact of chronic skin disease on daily life

PIQOL-AD

parent’s index of quality of life in atopic dermatitis

PQOL-AD

parents of children with atopic dermatitis

PSA

probabilistic sensitivity analysis

QALY

quality-adjusted life year

QOL

quality of life

RCT

randomized controlled trial

SF-36

short form-36

TCS

topical corticosteroids

VAS

visual analog scale

WTP

willingness-to-pay

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Copyright information

© Springer Science+Business Media LLC 2010

Authors and Affiliations

  • R. J. G. Arnold
    • 1
  • R. K. Kuan
    • 1
  1. 1.Department of Community and Preventive MedicineMount Sinai School of MedicineNew YorkUSA

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