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Healthcare Utilization and Costs Among US Adolescents With Alopecia Areata
Background: Alopecia areata (AA) is an autoimmune disease of hair loss affecting people of all ages. Alopecia totalis (AT) and universalis (AU) involve scalp and total body hair loss, respectively. AA significantly affects quality of life, but evidence on the economic burden in adolescents is limite...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Columbia Data Analytics, LLC
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9338344/ https://www.ncbi.nlm.nih.gov/pubmed/35975139 http://dx.doi.org/10.36469/001c.36229 |
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author | Ray, Markqayne Swallow, Elyse Gandhi, Kavita Carley, Christopher Sikirica, Vanja Wang, Travis Done, Nicolae Signorovitch, James Mostaghimi, Arash |
author_facet | Ray, Markqayne Swallow, Elyse Gandhi, Kavita Carley, Christopher Sikirica, Vanja Wang, Travis Done, Nicolae Signorovitch, James Mostaghimi, Arash |
author_sort | Ray, Markqayne |
collection | PubMed |
description | Background: Alopecia areata (AA) is an autoimmune disease of hair loss affecting people of all ages. Alopecia totalis (AT) and universalis (AU) involve scalp and total body hair loss, respectively. AA significantly affects quality of life, but evidence on the economic burden in adolescents is limited. Objectives: To assess healthcare resource utilization (HCRU) and all-cause direct healthcare costs, including out-of-pocket (OOP) costs, of US adolescents with AA. Methods: IBM MarketScan® Commercial and Medicare databases were used to identify patients aged 12-17 years with ≥2 claims with AA/AT/AU diagnosis (prevalent cases), from October 1, 2015, to March 31, 2018, enrolled for ≥12 months before and after the first AA diagnosis (index). Patients were matched 1:3 to non-AA controls on index year, demographics, plan type, and Charlson Comorbidity Index. Per patient per year HCRU and costs were compared post-index. Results: Patients comprised 130 AT/AU adolescents and 1105 non-AT/AU adolescents (53.8% female; mean age, 14.6 years). Post-index, AT/AU vs controls had more outpatient (14.5 vs 7.1) and dermatologist (3.6 vs 0.3) visits, higher mean plan costs ($9397 vs $2267), including medical ($7480 vs $1780) and pharmacy ($1918 vs $487) costs, and higher OOP costs ($2081 vs $751) (all P<.001). The non-AT/AU cohort vs controls had more outpatient (11.6 vs 8.0) and dermatologist (3.4 vs 0.4) visits, higher mean plan costs ($7587 vs $4496), and higher OOP costs ($1579 vs $805) (all P<.001). Discussion: This large-sample, real-world analysis found that adolescents with prevalent AA had significantly higher HCRU and all-cause costs than matched controls. The greater burden was driven by more frequent outpatient visits, and higher payer medical and pharmacy costs in comparison with controls. Oral corticosteroid use was higher among patients with AT/AU; topical and injectable corticosteroid use was higher for non-AT/AU. Although the data preclude the identification of AA-attributable costs, the matched-control design allows an estimation of incremental all-cause costs associated with AA. Conclusions: Adolescents with AA incurred substantial incremental healthcare costs, with greater costs incurred among those with AT/AU. Study findings suggest that AA incurs costs as a medical condition with a high burden on adolescent patients and health plans. |
format | Online Article Text |
id | pubmed-9338344 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Columbia Data Analytics, LLC |
record_format | MEDLINE/PubMed |
spelling | pubmed-93383442022-08-15 Healthcare Utilization and Costs Among US Adolescents With Alopecia Areata Ray, Markqayne Swallow, Elyse Gandhi, Kavita Carley, Christopher Sikirica, Vanja Wang, Travis Done, Nicolae Signorovitch, James Mostaghimi, Arash J Health Econ Outcomes Res Dermatological Diseases Background: Alopecia areata (AA) is an autoimmune disease of hair loss affecting people of all ages. Alopecia totalis (AT) and universalis (AU) involve scalp and total body hair loss, respectively. AA significantly affects quality of life, but evidence on the economic burden in adolescents is limited. Objectives: To assess healthcare resource utilization (HCRU) and all-cause direct healthcare costs, including out-of-pocket (OOP) costs, of US adolescents with AA. Methods: IBM MarketScan® Commercial and Medicare databases were used to identify patients aged 12-17 years with ≥2 claims with AA/AT/AU diagnosis (prevalent cases), from October 1, 2015, to March 31, 2018, enrolled for ≥12 months before and after the first AA diagnosis (index). Patients were matched 1:3 to non-AA controls on index year, demographics, plan type, and Charlson Comorbidity Index. Per patient per year HCRU and costs were compared post-index. Results: Patients comprised 130 AT/AU adolescents and 1105 non-AT/AU adolescents (53.8% female; mean age, 14.6 years). Post-index, AT/AU vs controls had more outpatient (14.5 vs 7.1) and dermatologist (3.6 vs 0.3) visits, higher mean plan costs ($9397 vs $2267), including medical ($7480 vs $1780) and pharmacy ($1918 vs $487) costs, and higher OOP costs ($2081 vs $751) (all P<.001). The non-AT/AU cohort vs controls had more outpatient (11.6 vs 8.0) and dermatologist (3.4 vs 0.4) visits, higher mean plan costs ($7587 vs $4496), and higher OOP costs ($1579 vs $805) (all P<.001). Discussion: This large-sample, real-world analysis found that adolescents with prevalent AA had significantly higher HCRU and all-cause costs than matched controls. The greater burden was driven by more frequent outpatient visits, and higher payer medical and pharmacy costs in comparison with controls. Oral corticosteroid use was higher among patients with AT/AU; topical and injectable corticosteroid use was higher for non-AT/AU. Although the data preclude the identification of AA-attributable costs, the matched-control design allows an estimation of incremental all-cause costs associated with AA. Conclusions: Adolescents with AA incurred substantial incremental healthcare costs, with greater costs incurred among those with AT/AU. Study findings suggest that AA incurs costs as a medical condition with a high burden on adolescent patients and health plans. Columbia Data Analytics, LLC 2022-07-29 /pmc/articles/PMC9338344/ /pubmed/35975139 http://dx.doi.org/10.36469/001c.36229 Text en https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (4.0) (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Dermatological Diseases Ray, Markqayne Swallow, Elyse Gandhi, Kavita Carley, Christopher Sikirica, Vanja Wang, Travis Done, Nicolae Signorovitch, James Mostaghimi, Arash Healthcare Utilization and Costs Among US Adolescents With Alopecia Areata |
title | Healthcare Utilization and Costs Among US Adolescents With Alopecia Areata |
title_full | Healthcare Utilization and Costs Among US Adolescents With Alopecia Areata |
title_fullStr | Healthcare Utilization and Costs Among US Adolescents With Alopecia Areata |
title_full_unstemmed | Healthcare Utilization and Costs Among US Adolescents With Alopecia Areata |
title_short | Healthcare Utilization and Costs Among US Adolescents With Alopecia Areata |
title_sort | healthcare utilization and costs among us adolescents with alopecia areata |
topic | Dermatological Diseases |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9338344/ https://www.ncbi.nlm.nih.gov/pubmed/35975139 http://dx.doi.org/10.36469/001c.36229 |
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