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The Challenge of Managing Atopic Dermatitis in the United States.

ABSTRACT: Background:Atopic dermatitis is a chronic inflammatory skin disease that affects up to 13% of children and 10% of adults in the United States. Among patients and their families, atopic dermatitis has a considerable effect on quality of life and represents a substantial economic burden. Objective:To describe the impact and challenges of atopic dermatitis and to provide nondermatologists in the healthcare community an enhanced understanding of atopic dermatitis to facilitate treatment and pharmacy benefit discussions. Discussion:Atopic dermatitis is a heterogeneous disease, and its diagnosis is hampered by a lack of objective diagnostic criteria. The current management guidelines address the distinct clinical phenotypes as a single disease and do not incorporate recent clinical advances, such as the targeting of specific inflammatory processes. The treatment guidelines for atopic dermatitis are complex and challenge healthcare providers, patients, and caregivers. Novel treatments can provide additional therapeutic options for patients with atopic dermatitis. Conclusions:Treatment options for atopic dermatitis are expanding with the development of novel anti-inflammatory therapies. An increased understanding of these advancements is necessary to optimize care for patients with atopic dermatitis.

SUBMITTER: Feldman SR

PROVIDER: S-EPMC6485648 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

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The Challenge of Managing Atopic Dermatitis in the United States.

Feldman Steven R SR Cox Linda S LS Strowd Lindsay C LC Gerber Robert A RA Faulkner Steven S Sierka Debra D Smith Timothy W TW Cappelleri Joseph C JC Levenberg Mark E ME

American health & drug benefits 20190401 2

<h4>Background</h4>Atopic dermatitis is a chronic inflammatory skin disease that affects up to 13% of children and 10% of adults in the United States. Among patients and their families, atopic dermatitis has a considerable effect on quality of life and represents a substantial economic burden.<h4>Objective</h4>To describe the impact and challenges of atopic dermatitis and to provide nondermatologists in the healthcare community an enhanced understanding of atopic dermatitis to facilitate treatme ...[more]

PMID: 31057694

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Project description:Abstract Background Atopic dermatitis (AD) is associated with elevated financial costs, including out‐of‐pocket (OOP) expenses. Yet, the full burden of OOP expenses in children with AD is poorly understood. Objectives We sought to characterise categories, impact, and associations of caregiver‐reported OOP AD healthcare expenses for US children. Methods An online survey was administered to National Eczema Association members (N = 113 502). Inclusion criteria (US resident; respondent age ≥18; self or caregiver report of AD diagnosis) was met by 77.3% (1118/1447) of those who completed the questionnaire. Results Caregivers of children (<18 years) with AD reported increased healthcare provider (HCP) visits, comorbid food allergy, cutaneous infections, and topical antimicrobial use (p < 0.005 for all), and increased OOP expenses for hospitalisation, emergency room visits, emollients, hygiene/bathing products, childcare, and specialised cleaning products, and clothing/bedding (p < 0.05 for all) compared to adults with AD. Children with AD had increased median total yearly OOP expenditures ($860 vs. $500, p = 0.002) and were more likely to spend ≥$1000 OOP per year (48.9% vs. 40.0%, p = 0.03). In children, yearly OOP expenses ≥$1000 were associated with increased AD severity, flares, HCP visits, prescription polypharmacy, and step‐up therapy use (p < 0.005 for all) compared with adults. Predictors of harmful financial impact among children included black race (adjusted OR [95% confidence interval]: 3.86 [1.66–8.98] p = 0.002) and ≥$1000 annual OOP expenditures (6.98 [3.46–14.08], p < 0.0001). Conclusion Children with AD have unique and increased OOP expenses that are associated with significant disease burden. Strategies are needed to reduce OOP costs and improve clinical outcomes in children with AD. Atopic dermatitis (AD) is associated with significant financial costs, including increased out‐of‐pocket (OOP) expenses. OOP healthcare expenses for AD are elevated for caregivers of children and are associated with increased disease activity. Healthcare providers should be mindful of this OOP financial burden strive to maximise clinical outcomes while minimising financial impact.

Dataset Information

The Challenge of Managing Atopic Dermatitis in the United States.

Publications

The Challenge of Managing Atopic Dermatitis in the United States.

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