Healthcare Resource Utilization and Costs in Patients with Itch-Dominant Moderate-to-Severe Atopic Dermatitis Treated in Private Dermatology Facilities in the United States
Moderator
Lawrence Rasouliyan, MPH, OMNY Health, Alpharetta, GA, United States
Speakers
Gil Yosipovitch; Matthew Zirwas; Amanda G Althoff, MS, OMNY Health, Atlanta, GA, United States; Danae Black, MPH, PhD, OMNY Health, Washington, DC, United States; Oliver Chambenoit; Lorenzo Sabatelli; Peter Lio
OBJECTIVES: The objectives were to characterize patients with moderate-to-severe atopic dermatitis (AD) by clinical phenotype and to assess relative healthcare resource utilization (HCRU) and costs in patients with severe itch and mild-to-moderate skin lesions.
METHODS: A retrospective analysis of electronic health records (EHR) and claims (2022-2024) of patients from United States-based dermatology facilities in the OMNY Health data platform was performed. Patients aged ≥ 12 years were indexed at their first EHR- or claims-based encounter with initiation of mid/high potency topical steroids, phototherapy, and/or systemic AD treatment. Documented severity of itch (with numerical rating score equal to 0-6 [MI] or 7-10 [SI]), and severity of skin lesions (with investigator global assessment score equal to 0-3 [ML] or 4 [SL]) was used to define 4 clinical phenotypes: MI-ML, MI-SL, SI-ML, and SI-SL. Multinomial propensity score weighting was applied to estimate and compare across phenotypes adjusted annualized 12-month outcomes.
RESULTS: 9,096 (of 256,386) moderate-to-severe patients with AD met eligibility criteria (62% MI-ML, 26% SI-ML, 2% MI-SL,10% SI-SL). Patients with SI-ML were older (median age: 58 years) and more likely to be female (65%), publicly insured (54%), with history of depression/anxiety (42%), type 2 diabetes (21%), and usage of topical corticosteroids (95%), opioids (42%), and sleep aids (10%). Following weighting and annualization, mean number of hospitalizations (2.4-3.0), emergency visits (2.9-3.2), and outpatient visits (4.9-6.4) were similar across phenotypes; however, SI-ML patients exhibited the highest mean hospitalization charges ($8,546; minimum: $4,942 [MI-SL]) and second highest mean emergency visit charges ($6,100; range: $5,181-$6,707) and outpatient visit charges ($13,065; range: $4,510-$44,256). Concurrently, SI-ML patients exhibited the lowest mean pharmacy charges ($29,913; maximum: $45,255 [MI-SL]).
CONCLUSIONS: Results suggest a relationship between AD clinical phenotype and healthcare charges. Patients with SI-ML appear to have significant need for high-cost healthcare, while not consistently accessing the same pharmaceutical resources as other clinical phenotypes.
METHODS: A retrospective analysis of electronic health records (EHR) and claims (2022-2024) of patients from United States-based dermatology facilities in the OMNY Health data platform was performed. Patients aged ≥ 12 years were indexed at their first EHR- or claims-based encounter with initiation of mid/high potency topical steroids, phototherapy, and/or systemic AD treatment. Documented severity of itch (with numerical rating score equal to 0-6 [MI] or 7-10 [SI]), and severity of skin lesions (with investigator global assessment score equal to 0-3 [ML] or 4 [SL]) was used to define 4 clinical phenotypes: MI-ML, MI-SL, SI-ML, and SI-SL. Multinomial propensity score weighting was applied to estimate and compare across phenotypes adjusted annualized 12-month outcomes.
RESULTS: 9,096 (of 256,386) moderate-to-severe patients with AD met eligibility criteria (62% MI-ML, 26% SI-ML, 2% MI-SL,10% SI-SL). Patients with SI-ML were older (median age: 58 years) and more likely to be female (65%), publicly insured (54%), with history of depression/anxiety (42%), type 2 diabetes (21%), and usage of topical corticosteroids (95%), opioids (42%), and sleep aids (10%). Following weighting and annualization, mean number of hospitalizations (2.4-3.0), emergency visits (2.9-3.2), and outpatient visits (4.9-6.4) were similar across phenotypes; however, SI-ML patients exhibited the highest mean hospitalization charges ($8,546; minimum: $4,942 [MI-SL]) and second highest mean emergency visit charges ($6,100; range: $5,181-$6,707) and outpatient visit charges ($13,065; range: $4,510-$44,256). Concurrently, SI-ML patients exhibited the lowest mean pharmacy charges ($29,913; maximum: $45,255 [MI-SL]).
CONCLUSIONS: Results suggest a relationship between AD clinical phenotype and healthcare charges. Patients with SI-ML appear to have significant need for high-cost healthcare, while not consistently accessing the same pharmaceutical resources as other clinical phenotypes.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE169
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Sensory System Disorders (Ear, Eye, Dental, Skin)