Healthcare Resource Utilization and Costs in Patients with Itch-Dominant Moderate-to-Severe Atopic Dermatitis Treated in Private Dermatology Facilities in the United States
Author(s)
Gil Yosipovitch, MD1, Matthew Zirwas, MD2, Lawrence Rasouliyan, MPH3, Amanda Grace Althoff, MS3, Danae Black, MPH, PhD3, Oliver Chambenoit, PhD4, Lorenzo Sabatelli, PhD5, Peter Lio, MD6.
1Miller School of Medicine, University of Miami, Miami, FL, USA, 2Bexley Dermatology Research Clinic, Bexley, OH, USA, 3OMNY Health, Atlanta, GA, USA, 4Galderma, Boston, MA, USA, 5Galderma, Zug, Switzerland, 6Medical Dermatology Associates of Chicago, Chicago, IL, USA.
1Miller School of Medicine, University of Miami, Miami, FL, USA, 2Bexley Dermatology Research Clinic, Bexley, OH, USA, 3OMNY Health, Atlanta, GA, USA, 4Galderma, Boston, MA, USA, 5Galderma, Zug, Switzerland, 6Medical Dermatology Associates of Chicago, Chicago, IL, USA.
Presentation Documents
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)