Willingness to pay and quality of life in patients with atopic dermatitis.

Atopic dermatitis (AD) is a frequent and burdensome disease. The objectives of this study were (1) to assess the willingness to pay (WTP) and quality of life (Qol) in AD patients and (2) to compare the results with data on other chronic skin diseases. To collect data, a non-interventional, cross-sectional nationwide postal survey on adult patients with clinically diagnosed AD was performed; socio-demographic data, clinical features/symptoms, WTP and QoL were recorded. WTP was assessed in three different approaches, including relative and absolute figures. Data from n = 384 AD patients (mean age 42.0, range 18-92, 69.8 % female) were analyzed. WTP for complete healing was on median 1,000 (average 11,884) and exceeded WTP in rosacea (median 500) but not in vitiligo (median 3,000). Mean Dermatology Life Quality Index (DLQI) was 8.5 (vitiligo 7.0; psoriasis 6.7; rosacea 4.3) and correlated with pruritus, xerosis and disturbed sleep. WTP and DLQI correlated only marginally (r s = 0.134, p = 0.01). In conclusion, AD patients show high WTP and markedly reduced QoL compared to other chronic skin diseases.

Willingness to pay and quality of life in patients with rosacea.

BACKGROUND: Rosacea is a chronic inflammatory dermatosis affecting >2% of the population. Willingness to pay (WTP) is a well established method which reflects the individual burden of disease. OBJECTIVES: Evaluation of WTP and quality of life (QoL) in patients with rosacea. METHODS: Nationwide postal survey on adult patients with rosacea affiliated with the German rosacea patient advocacy group. WTP was evaluated by three standardized items and compared to historical data on vitiligo (n = 1023). QoL was assessed using the Dermatology Life Quality Index (DLQI). RESULTS: Data from n = 475 rosacea patients (79.9% women, mean age 56.3, range 26-90) were analysed. On average, patients were willing to pay € 2880 (median € 500) for complete healing compared with € 7360 (median € 3000) in vitiligo. Relative WTP was higher in women; the highest sums were registered for the age group 21-30 years. The extent of facial involvement predicted a higher relative WTP, whereas WTP decreased with the duration of symptoms and age. Mean DLQI total score was 4.3 compared to 7.0 in vitiligo. In rosacea, the highest values were observed in patients <30 years. Severe QoL reductions (DLQI>10) were less frequent (11%) than in vitiligo (24.6%). The correlation between WTP and DLQI was significant (e.g. r = 0.249, P = 0.000 for relative WTP). CONCLUSION: Rosacea patients show a moderate WTP and average QoL reduction is mild. WTP proved to be a valid tool to assess patients' burden of disease. Patient education and the development of effective treatment options might still improve patients' satisfaction.

Quality of health care of rosacea in Germany from the patient's perspective: results of the national health care study Rosareal 2009.

OBJECTIVES: To obtain reliable data on quality of care of rosacea and to compare care indicators with those found in atopic dermatitis and psoriasis. PATIENTS AND METHODS: In this cross-sectional study, clinical history, health-related quality of life (HrQoL), medication and treatment benefit of patients with rosacea were assessed by standardized questionnaires. Data were compared to patients with atopic dermatitis and psoriasis. RESULTS: Almost all 475 participants (96.4%) had received topical therapy. 24% had used cortisone ointments. The mean Dermatology Life Quality Index (DLQI) was 4.3 ± 4.6 (atopic dermatitis: 8.5 ± 6.0, psoriasis: 6.7 ± 6.2). The Patient Benefit Index (patient-defined therapeutic benefit) was 1.9 ± 1.2 (psoriasis: 2.3 ± 1.1, atopic dermatitis: 2.1 ± 1.1). CONCLUSIONS: Only a small proportion of the rosacea patients had substantial impairments in HrQoL. Overall, their burden appears to be lower than in patients with atopic dermatitis or psoriasis. However, the lower therapeutic benefit and the high proportion of topical steroid use indicate a need for optimized therapy.

Internet-supported gathering of treatment data and patient benefits in psoriasis.

BACKGROUND: Studies about health care of psoriasis patients in Germany are predominantly carried out in dermatological centres, which results in a certain selection bias. To collect data from other sources of patients, the German Centre of Health Services Research in Dermatology conducted a series of web-based studies. The extent of how data on health care on psoriasis gathered online vary from paper and pencil data is yet to be explored. OBJECTIVE: 1 To collect reliable treatment and benefit online data from psoriasis patients in Germany. 2 To compare these with data gathered at dermatological centres. METHODS: On the 'psoriasis-hilfe.de' web portal, psoriasis patients were asked to complete the online version of a questionnaire, which has already been used as a paper and pencil version in the national psoriasis study 'PsoHealth'. Subsequently, difference analyses were conducted between the two data sets. RESULTS: The PsoWeb sample (n = 1071) varies to a high extent from the PsoHealth sample (n = 2009) regarding the achievement of treatment goals and treatment satisfaction. Irrespective of age, sex and duration of disease, the online sample showed lower treatment satisfaction and fewer patient-defined benefits. CONCLUSION: The findings suggest that patients in the online sample are less satisfied with their health care, which also could have been their motive for participating online. It is important to gather data online because it increases the data pool and permits inclusion of people who are not incorporated in clinical settings. However, online data cannot directly replace data collected in clinics because they are also subject to selections.