Association Between Having a Diagnosis for Pruritus and Higher Healthcare Resource Utilization and Cost Among Patients Newly Initiating Systemic Therapy for Atopic Dermatitis: A Matched Case-Control Analysis of US Claims Data

OBJECTIVES: Atopic dermatitis (AD) is a common, chronic, inflammatory skin disease characterized by severe persistent itch. This study used US claims data to describe healthcare resource utilizations and costs in patients with AD with a recorded additional itch diagnosis versus matched AD controls.

METHODS: Patients with AD were identified (via the ICD-10-CM L20.xx code) in the MarketScan claims databases as they initiated systemic treatment with oral corticosteroids, immunosuppressants, or biologics, between 1/1/2017 and 6/30/2022 (index = first treatment), and were required to be continuously enrolled for 12 months before (baseline) and after index (follow-up).

Patients with AD that had at least one claim with an additional diagnosis for pruritus (itch-diagnosed), of any form, anytime at baseline or during follow-up, were identified. Controls were selected among patients with AD that did not have a recorded diagnosis of itch. Propensity score matching was used to balance itch-diagnosed and control cohorts (1:1) on baseline demographic and clinical characteristics. Healthcare resource utilization and costs were compared among itch-diagnosed cases and controls.

RESULTS: There were 3,917 itch-diagnosed patients and matched control patients eligible (mean/median age 30.5/27 and 30.3/26, standardized difference 0.01, 58.6% and 56.6% female, standardized differences 0.04; mean Charlson comorbidity score 0.41, 0.39, standardized difference 0.03). Compared with matched controls, during follow-up itch-diagnosed patients were more likely to have an inpatient admission (4.8% vs. 3.7%; p<0.05), had a higher mean number of prescriptions (23.0 vs. 19.5; p<0.001) and office visits (10.9 vs. 8.9; p<0.001), and incurred on average higher medical ($9,009 vs. $7,351) and total healthcare ($20,207 vs. $15,608) costs (p<0.001).

CONCLUSIONS: Patients with AD that had ever received an additional diagnosis of itch had significantly higher healthcare resource utilization and costs. While further research on the burden of itch is needed, these study results suggest that itch significantly increases the overall economic burden associated with AD.