RESUMEN
Alopecia areata (AA) is an autoimmune disorder that manifests as nonscarring hair loss and imposes a substantial disease burden. The current study, using an e-claims database, assesses the disease burden, comorbidities, treatment patterns, specialties involved in the diagnosis of AA, healthcare resource utilization (HCRU), and associated costs in privately insured patients with AA in Dubai, United Arab Emirates. The retrospective longitudinal secondary study was conducted using Dubai Real-World Database e-claims data during 01 January 2014 to 30 June 2022. Patients with at least one diagnosis claim of AA during the index period (01 January 2015-30 June 2021) with continuous enrollment (one or more AA/non-AA claim in the post-index period) were included in the analysis. The patients were stratified into subcohorts based on diagnosis code and treatment patterns, as mild, moderate-to-severe, and others. Demographics, comorbidities, treatment patterns, specialists visited, and HCRU were assessed. The study included 11 851 patients with AA (mean age: mild: 37 years; moderate-to-severe: 36 years), with a male predominance (mild: 77.6%; moderate-to-severe: 60.8%). The most prevalent comorbidities in the moderate-to-severe AA subcohort were autoimmune and T-helper 2-mediated immune disorders, including contact dermatitis and eczema (62.1%), atopic dermatitis (36.1%), and asthma (36.1%). Most patients consulted dermatologists for treatment advice (mild AA: 87.4%; moderate-to-severe AA: 47.7%) and, notably, within 1 day of AA diagnosis. Topical steroids were frequently prescribed across cohorts, regardless of disease severity. Analysis of comorbidities among patients with AA indicated an additional HCRU burden among these subsets of patients. The median disease-specific HCRU cost was higher for psychological comorbidities versus autoimmune and T-helper 2-mediated immune disorders (US $224.99 vs US $103.70). There is a substantial disease and economic burden in patients with AA and associated comorbid conditions; therefore, investing in novel therapies that target the underlying autoimmune pathway may address the gap in effective management of AA.
Asunto(s)
Alopecia Areata , Comorbilidad , Costo de Enfermedad , Bases de Datos Factuales , Humanos , Alopecia Areata/terapia , Alopecia Areata/epidemiología , Alopecia Areata/economía , Alopecia Areata/diagnóstico , Emiratos Árabes Unidos/epidemiología , Masculino , Femenino , Estudios Retrospectivos , Adulto , Persona de Mediana Edad , Adulto Joven , Adolescente , Aceptación de la Atención de Salud/estadística & datos numéricos , Niño , Índice de Severidad de la Enfermedad , Estudios Longitudinales , Costos de la Atención en Salud/estadística & datos numéricos , Preescolar , AncianoRESUMEN
Alopecia areata (AA) is a chronic autoimmune disease that causes non-scarring hair loss. Data are lacking on the epidemiology and clinical and economic burden of AA in Spain. To estimate the prevalence and incidence of AA in Spain and describe sociodemographic and clinical characteristics, treatment patterns, healthcare resource utilization (HCRU) and associated costs. This was an observational, retrospective, descriptive study based on the Health Improvement Network (THIN®) database (Cegedim Health Data, Spain). Patients with ICD9-Code 704.01 for AA, registered between 2014 and 2021, were identified. Prevalence (%) and incidence rates per 1,000 patient-years (IR) of AA were calculated and clinical characteristics, treatment characteristics and HCRU/costs were assessed. A total of 5,488 patients with AA were identified. The point prevalence of AA in 2021 was 0.44 (95% confidence interval [CI]: 0.43-0.45) overall, 0.48 (0.47-0.49) in adults, and 0.23 (0.21-0.26) in children ≤12 years. The 2021 IR for AA in adults was 0.55 (0.51-0.60). Of 3,351 adults with AA, 53.4% were female, mean (standard deviation [SD]) age was 43.1 (14.7) years, and 41.6% experienced comorbidities. Among adults, 2.7% used systemic treatment (0.5% immunosuppressants, 2.5% oral corticosteroids, 0.3% both). Laboratory tests and health care professional visits were the principal drivers of cost, which was 821.2 (1065.6)/patient in the first year after diagnosis. The epidemiology of AA in Spain is comparable with that reported for other countries, being more prevalent among adults. There is a significant burden of comorbidities and cost for patients, with limited use of systemic treatments, suggesting an unmet treatment need in this population.
Asunto(s)
Alopecia Areata , Costo de Enfermedad , Costos de la Atención en Salud , Humanos , España/epidemiología , Alopecia Areata/epidemiología , Alopecia Areata/economía , Estudios Retrospectivos , Femenino , Masculino , Adulto , Prevalencia , Niño , Costos de la Atención en Salud/estadística & datos numéricos , Incidencia , Persona de Mediana Edad , Adolescente , Adulto Joven , Preescolar , Inmunosupresores/uso terapéutico , Inmunosupresores/economía , AncianoRESUMEN
Alopecia areata (AA) is managed with prolonged medical treatments and cosmetic therapies, whose cost can be burdensome. We sought to identify the costs of AA treatment and consolidate the available data for the practicing dermatologist by performing a PubMed search of articles indexed for MEDLINE. Ten studies including approximately 16,000 patients with AA across a range of Oxford Centre for Evidence-Based Medicine Levels of Evidence were included. Studies showed that despite the limited efficacy of many AA therapies, patients incurred substantial expenses to manage their AA.
Asunto(s)
Alopecia Areata , Costo de Enfermedad , Alopecia Areata/economía , Alopecia Areata/terapia , Alopecia Areata/tratamiento farmacológico , Humanos , Costos de la Atención en Salud/estadística & datos numéricos , Dermatólogos/economía , Fármacos Dermatológicos/economía , Fármacos Dermatológicos/administración & dosificación , Fármacos Dermatológicos/uso terapéuticoAsunto(s)
Alopecia Areata , Análisis Costo-Beneficio , Medicamentos Genéricos , Piperidinas , Pirimidinas , Pirroles , Humanos , Piperidinas/uso terapéutico , Piperidinas/efectos adversos , Piperidinas/economía , Alopecia Areata/tratamiento farmacológico , Alopecia Areata/economía , Pirimidinas/economía , Pirimidinas/uso terapéutico , Pirimidinas/efectos adversos , Estudios Retrospectivos , Medicamentos Genéricos/economía , Medicamentos Genéricos/efectos adversos , Medicamentos Genéricos/uso terapéutico , Femenino , Masculino , Adulto , Resultado del Tratamiento , Pirroles/economía , Pirroles/uso terapéutico , Pirroles/efectos adversos , Inhibidores de Proteínas Quinasas/efectos adversos , Inhibidores de Proteínas Quinasas/economía , Inhibidores de Proteínas Quinasas/uso terapéutico , Persona de Mediana Edad , Adulto JovenRESUMEN
BACKGROUND: This real-world analysis aimed at characterizing patients hospitalized for alopecia areata (AA) in Italy, focusing on comorbidities, treatment patterns and the economic burden for disease management. METHODS: Administrative databases of healthcare entities covering 8.9 million residents were retrospectively browsed to include patients of all ages with hospitalization discharge diagnosis for AA from 2010 to 2020. The population was characterized during the year before the first AA-related hospitalization (index-date) and followed-up for all the available successive period. AA drug prescriptions and treatment discontinuation were analyzed during follow-up. Healthcare costs were also examined. RESULTS: Among 252 patients with AA (mean age 32.1 years, 40.9% males), the most common comorbidities were thyroid disease (22.2%) and hypertension (21.8%), consistent with literature; only 44.4% (112/252) received therapy for AA, more frequently with prednisone, triamcinolone and clobetasol. Treatment discontinuation (no prescriptions during the last trimester) was observed in 86% and 88% of patients, respectively at 12 and 24-month after therapy initiation. Overall healthcare costs were 1715 per patient (rising to 2143 in the presence of comorbidities), mostly driven by hospitalization and drugs expenses. CONCLUSIONS: This first real-world description of hospitalized AA patients in Italy confirmed the youth and female predominance of this population, in line with international data. The large use of corticosteroids over other systemic therapies followed the Italian guidelines, but the high discontinuation rates suggest an unmet need for further treatment options. Lastly, the analysis of healthcare expenses indicated that hospitalizations and drugs were the most impactive cost items.
Asunto(s)
Alopecia Areata , Hospitalización , Humanos , Italia/epidemiología , Alopecia Areata/epidemiología , Alopecia Areata/economía , Alopecia Areata/terapia , Masculino , Femenino , Adulto , Estudios Retrospectivos , Hospitalización/economía , Hospitalización/estadística & datos numéricos , Adolescente , Adulto Joven , Persona de Mediana Edad , Niño , Costos de la Atención en Salud/estadística & datos numéricos , Comorbilidad , Preescolar , Enfermedades de la Tiroides/epidemiología , Enfermedades de la Tiroides/economía , Enfermedades de la Tiroides/terapia , Hipertensión/epidemiología , Hipertensión/tratamiento farmacológico , Hipertensión/economía , AncianoRESUMEN
Previous QOL and disease burden studies have not captured all relevant aspects of living with alopecia areata (AA). To better understand the burden and everyday experience of living with moderate-to-severe AA, a cross-sectional, online, quantitative-qualitative survey was developed to assess symptoms, relationships, productivity, treatments, and financial burden. Adult patients were recruited from the National Alopecia Areata Foundation database. Data were analyzed descriptively. A total of 216 patients completed the survey. Most were female (83%), aged ≥45 years (59%), and white (78%). Nearly 2 of 3 respondents (62%) made different major life decisions (regarding relationships, education, or career) owing to AA. Most respondents (85%) stated coping with AA as a daily challenge, citing mental health issues, concealing hair loss, and others' reactions; 47% reported anxiety and/or depression. Many patients (75%) persistently concealed hair loss (mean time spent, 10.3 h/wk). Treatment discontinuation was common owing to lack of efficacy, side effects, and cost. Associated expenditures included buying wigs or hairpieces and psychotherapy (mean â¼$2,000/y each). Survey respondents comprised a self-selected sample, which may not reflect the entire population. The impact of AA extends beyond cosmetic concerns and carries a considerable psychosocial burden. Efficacious, less burdensome AA treatments are needed to regrow hair and alleviate psychosocial sequelae.