TRENDS IN ATOPIC DERMATITIS MEDICATION UTILIZATION AND PHARMACY COSTS IN PEDIATRIC COMMERCIAL AND MEDICAID POPULATIONS
Author(s)
Steven C. Do, PharmD1, Jodi Schreiber, BS2, Cindy M. Chan, PharmD1, Tiffany Lee, PhD2, Samuel Peasah, PhD, Rph, MBA3, Angela Inneh, MPH, MBA2, C. Bernie Good, MPH, MD3;
1University of Pittsburgh School of Pharmacy, Pittsburgh, PA, USA, 2Evernorth, St Louis, MO, USA, 3UPMC Health Plan, Pittsburgh, PA, USA
1University of Pittsburgh School of Pharmacy, Pittsburgh, PA, USA, 2Evernorth, St Louis, MO, USA, 3UPMC Health Plan, Pittsburgh, PA, USA
OBJECTIVES: To measure atopic dermatitis (AD) medication utilization and pharmacy costs among pediatric patients between 2019 and 2024 by insurance type and age group.
METHODS: A cross-sectional analysis was performed using a national pharmacy claims database spanning January 2019 through December 2024. Pediatric patients (<18 years) with ≥2 AD diagnoses with a calendar year were included and classified into 3 groups: young children (6 months to <6 years), children (6 to <12 years), and adolescents (12 to <18 years). For each insurance type, medication utilization and pharmacy cost were evaluated as prescriptions per 1,000 patients, relative utilization by medication class, and relative pharmacy cost by drug class
RESULTS: Prescriptions per 1,000 patients increased from 2019 to 2024 by 15.9%, 31.5%, and 24.5% for young children, children, and adolescents with commercial plans, and by 11.6%, 34.7%, and 10.7% in Medicaid. Across all subgroups in 2024, topical corticosteroids remained the most frequently prescribed therapy (58-82% of prescriptions) but contributed less to pharmacy costs (3-17% of costs). Dupilumab utilization increased following age-group approvals and became the dominant driver of pharmacy costs across all eligible groups, particularly among children (6 to <12 years) in the Medicaid population, where dupilumab represented only 5% of prescriptions but accounted for 84% of pharmacy costs in 2024. Systemic Janus kinase inhibitors, approved in 2022 for adolescents, had limited uptake but accounted for 19% of costs in the Medicaid population and 9% in the commercial population.
CONCLUSIONS: Dupilumab is the primary pharmacy cost driver for pediatric AD, while topical corticosteroids remain the most utilized therapy. These findings provide early insight into how new AD treatments influence utilization and pharmacy costs for pediatric patients.
METHODS: A cross-sectional analysis was performed using a national pharmacy claims database spanning January 2019 through December 2024. Pediatric patients (<18 years) with ≥2 AD diagnoses with a calendar year were included and classified into 3 groups: young children (6 months to <6 years), children (6 to <12 years), and adolescents (12 to <18 years). For each insurance type, medication utilization and pharmacy cost were evaluated as prescriptions per 1,000 patients, relative utilization by medication class, and relative pharmacy cost by drug class
RESULTS: Prescriptions per 1,000 patients increased from 2019 to 2024 by 15.9%, 31.5%, and 24.5% for young children, children, and adolescents with commercial plans, and by 11.6%, 34.7%, and 10.7% in Medicaid. Across all subgroups in 2024, topical corticosteroids remained the most frequently prescribed therapy (58-82% of prescriptions) but contributed less to pharmacy costs (3-17% of costs). Dupilumab utilization increased following age-group approvals and became the dominant driver of pharmacy costs across all eligible groups, particularly among children (6 to <12 years) in the Medicaid population, where dupilumab represented only 5% of prescriptions but accounted for 84% of pharmacy costs in 2024. Systemic Janus kinase inhibitors, approved in 2022 for adolescents, had limited uptake but accounted for 19% of costs in the Medicaid population and 9% in the commercial population.
CONCLUSIONS: Dupilumab is the primary pharmacy cost driver for pediatric AD, while topical corticosteroids remain the most utilized therapy. These findings provide early insight into how new AD treatments influence utilization and pharmacy costs for pediatric patients.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
HSD15
Topic
Health Service Delivery & Process of Care
Disease
SDC: Pediatrics