The annual cost of medical care for patients with moderate to severe atopic dermatitis in Mexico. A multicenter study
PDF (Spanish)
PubMed

Supplementary Files

XML (Spanish)

Keywords

Atopic dermatitis
Eczema
Direct medical costs

Abstract

Background: In Mexico, the economic burden of medical care for patients with atopic dermatitis is unknown.

Objective: To determine the annual direct medical costs of the treatment for patients with moderate to severe atopic dermatitis who receive medical attention at  “Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado” (Institute for Social Security and Social Services for State Workers, better known as ISSSTE), as well as the main variables associated with it.

Methods: A multicenter, retrospective cohort study. Clinical records of patients with moderate to severe atopic dermatitis were reviewed and a multivariate analysis was designed by using a generalized linear model.

Results: 65 patients were included; 41 of them (63.07 %) had moderate atopic dermatitis, and 24 (36.92 %) had severe AD; 39 (60 %) of them were female patients. In groups with severe atopic dermatitis, statistically significant differences were observed in matters of the duration of the evolution of the disease, comorbidities, intense pruritus, and depression. The average annual cost of medical care for patients with moderate atopic dermatitis was 1527 ± 623 USD, and for patients with severe atopic dermatitis the cost was 9487 ± 8990 USD. Significant differences were observed in dermatology consultations, referrals, laboratory and diagnostic studies, and the number of drugs prescribed by physicians. With the multivariate analysis, it was identified that the highest cost was presented by severe patients (p = 0.0001) who were younger and had comorbidities, along with diagnosis of depression.

Conclusions: The severity of atopic dermatitis, the age average, the presence of comorbidities, and the diagnosis of depression are the variables with the highest association and impact on the direct cost of medical care.

PDF (Spanish)
PubMed

References

Eichenfield L, Tom W, Berger T, Krol A, Paller AS, Schwarzenberger K, et al. Guidelines of care for the management of atopic dermatitis: Section 2. Management and treatment of atopic dermatitis with topical therapies. J Am Acad Dermatol. 2014;71(1):116-132. DOI: 10.1016/j.jaad.2014.03.023

Sidbury R, Davis D, Cohen D, Cordoro KM, Berger TG, Bergman JN, et al. Guidelines of care for the management of atopic dermatitis: Section 3. Management and treatment with phototherapy and systemic agents. J Am Acad Dermatol. 2014;71(2):327-349. DOI: 10.1016/j.jaad.2014.03030

Schneider LC. Ditching the itch with anti-type 2 cytokine therapies for atopic dermatitis. N Engl J Med. 2017;376(9):878-879. DOI: 10.1056/NEJMe1616072

Boguniewicz M. Biologic therapy for atopic dermatitis: moving beyond the practice parameter and guidelines. J Allergy Clin Immunol Pract. 2017;5(6):1477-1487. DOI: 10.1016/j.jaip.2017.08.031

Boguniewicz M, Fonacier L, Guttman-Yassky E, Ong PY, Silverberg J, Farrar JR. Atopic dermatitis yardstick: Practical recommendations for an evolving therapeutic landscape. Ann Allergy Asthma Immunol. 2018;120(1):10-22. DOI: 10.1016/j.anai.2017.10.039

Weidinger S, Beck LA, Bieber T, Kabashima K, Irvine AD. Atopic dermatitis. Nat Rev Dis Primers. 2018;4(1):1. DOI: 10.1038/s41572-018-0001-z

Centro Nacional de Excelencia Tecnológica en Salud. Diagnóstico y tratamiento de dermatitis por contacto en adultos. México: Centro Nacional de Excelencia Tecnológica en Salud; 2017.

Silverberg JI, Hanifin JM. Adult eczema prevalence and associations with asthma and other health and demographic factors: A US population-based study. J Allergy Clin Immunol. 2013;132(5):1132-1138. DOI: 10.1016/j.jaci.2013.08.031

Simpson EL, Bieber T, Eckert L, Wu R, Ardeleanu M, Graham NMH, et al. Patient burden of moderate to severe atopic dermatitis (AD): Insights from a phase 2b clinical trial of dupilumab in adults. J Am Acad Dermatol. 2016;74(3):491-498. DOI: 10.1016/j.jaad.2015.10.043

Blome C, Radtke MA, Eissing L, Augustin M. Quality of life in patients with atopic dermatitis: Disease burden, measurement, and treatment benefit. Am J Clin Dermatol. 2016;17(2):163-169. DOI: 10.1007/s40257-015-0171-3

Holm JG, Agner T, Clausen ML, Thomsen SF. Quality of life and disease severity in patients with atopic dermatitis. J Eur Acad Dermatol Venereol. 2016;30(10):1760-1767. DOI: 10.1111/jdv.13689

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. DOI: 10.1111/j.1525-1470.2007.00572.x

Drucker AM, Wang AR, Li WQ, Sevetson E, Block JK, Qureshi AA, et al. The burden of atopic dermatitis: Summary of a report for the National Eczema Association. J Invest Dermatol. 2017;137(1):26-30. DOI: 10.1016/j.jid.2016.07.012

Narla S, Hsu DY, Thyssen JP, Silverberg JI. Inpatient financial burden of atopic dermatitis in the United States. J Invest Dermatol. 2017;137(7):1461-1467. DOI: 10.1016/j.jid.2017.02.975

Silverberg JI. Public health burden and epidemiology of atopic dermatitis. Dermatol Clin. 2017;35(3):283-289. DOI: 10.1016/j.det.2017.02.002

Adamson AS. The economics burden of atopic dermatitis. Adv Exp Med Biol. 2017;1027:79-92. DOI: 10.1007/978-3-319-64804-0_8

Shrestha S, Miao R, Wang L, Chao J, Yuce H, Wei W. Burden of atopic dermatitis in the United States: analysis of healthcare claims data in the Commercial, Medicare, and Medi-Cal databases. Adv Ther. 2017;34(8):1989-2006. DOI: 10.1007/s12325-017-0582-z

Eckert L, Gupta S, Amand C, Gadkari A, Mahajan P, Gelfand JM. The burden of atopic dermatitis in US adults: Health care resource utilization data from the 2013 National Health and Wellness Survey. J Am Acad Dermatol. 2018;78(1):54-61. DOI: 10.1016/j.jaad.2017.08.002

Kwa L, Silverberg JI. Financial burden of emergency department visits for atopic dermatitis in the United States. J Am Acad Dermatol. 2018;79(3):443-447. DOI: 10.1016/j.jaad.2018.05.025

Karimkhani C, Delavalle RP, Coffeng LE, Flohr C, Hay RJ, Langan SM, et al. Global skin disease morbidity and mortality: An update from the Global Burden of Disease study 2013. JAMA Dermatol. 2017;153(5):406-412. DOI: 10.1001/jamadermatol.2016.5538

Kim C, Park KY, Ahn S, Kim DH, Li K, Kim DW, et al. Economic impact of atopic dermatitis in Korean patients. Ann Dermatol. 2015;27(3):298-305. DOI: 10.5021/ad.2015.27.3.298

Arima K, Gupta S, Gadkari A, Hiragun T, Kono T, Katayama I, et al. Burden of atopic dermatitis in Japanese adults: Analysis of data from the 2013 National Health and Wellness survey. J Dermatol. 2018;45(4):390-396. DOI: 10.1111/1346-8138

International Eczema Council [sitio web]. Validated Investigador Global Assesment for Atopic Dermatitis (VIGA-ADTM™) Scale. EE. UU.: International Eczema Council; 2017. Disponible en: https://www.eczemacouncil.org/research/investigator-global-assessment-scale/

Banco Mundial [sitio web]. Informe anual 2019. EE. UU.: Banco Mundial; 2019. Disponible en: https://www.bancomundial.org/es/about/annual-report

Fondo Monetario Internacional [sitio web]. Informe anual del FMI 2019. EE. UU.: Fondo Monetario Internacional; 2019. Disponible en: https://www.imf.org/external/pubs/ft/ar/2019/eng/assets/pdf/imf-annual-report-2019-es.pdf

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Copyright (c) 2020 Revista Alergia México

Downloads

Download data is not yet available.