Impact of Dupilumab on Mental Health Service Utilization in Patients With Atopic Dermatitis in a Colombian Health Insurance Provider: An Observational Real-World Practice Study
Author(s)
Jhon E. Bolaños, MD, MSc1, Carlos Bello, MSc1, Luz Eugenia Perez Jaramillo, MD, MSc1, Farley Gonzalez, MD, MSc1, Sergio Londono, MPH2, YURI MARCELA TORRES, MSc2.
1Seguros SURA Colombia, Medellin, Colombia, 2Sanofi Aventis, Bogota, Colombia.
1Seguros SURA Colombia, Medellin, Colombia, 2Sanofi Aventis, Bogota, Colombia.
OBJECTIVES: To evaluate the impact of dupilumab on the use of mental health services in patients with atopic dermatitis (AD).
METHODS: A retrospective cohort study was conducted in patients with AD treated with dupilumab and affiliated with a Colombian health insurance provider between 2018 and 2023. Data were collected from electronic medical records, including clinical and sociodemographic variables, as well as the use of mental health services—specifically, emergency department visits related to mood, anxiety, or stress-related disorders (identified using ICD-10 codes), and consultations with psychology or psychiatry. Two time periods were analyzed: 52 weeks before and 52 weeks after treatment initiation. Changes in service utilization were assessed using McNemar’s test, with p<0.05 considered statistically significant.
RESULTS: A total of 547 patients with AD were included; 51.9% were male, with a median age of 23 years (IQR:16-33). The most frequent comorbidities were allergic rhinitis (38.9%) and asthma (19.2%). In the subgroup with prior psychological or psychiatric care, the proportion of patients who remained in follow-up declined after initiating dupilumab. Among those with previous psychological consultations (n=124), 64.5% continued follow-up during the treatment period (p<0.0001), despite an increase in the median number of visits [from 1(IQR:1-2) to 2(IQR:1-3)]. Among patients with prior psychiatric care (n = 62), only 48.4% maintained follow-up (p<0.0001), with a stable median number of visits [2(IQR:1-3) in both periods]. Psychiatric emergency visits were infrequent. In all patients with a personal history, recurrence was observed during follow-up. No new cases of recurrent depressive disorder or phobic anxiety disorder were identified.
CONCLUSIONS: Initiation of dupilumab in patients with AD and prior mental health care was associated with reduced follow-up needs of psychologic and psychiatric care. These findings suggest a potential stabilizing effect on mental health and improved overall disease management in real-world settings.
METHODS: A retrospective cohort study was conducted in patients with AD treated with dupilumab and affiliated with a Colombian health insurance provider between 2018 and 2023. Data were collected from electronic medical records, including clinical and sociodemographic variables, as well as the use of mental health services—specifically, emergency department visits related to mood, anxiety, or stress-related disorders (identified using ICD-10 codes), and consultations with psychology or psychiatry. Two time periods were analyzed: 52 weeks before and 52 weeks after treatment initiation. Changes in service utilization were assessed using McNemar’s test, with p<0.05 considered statistically significant.
RESULTS: A total of 547 patients with AD were included; 51.9% were male, with a median age of 23 years (IQR:16-33). The most frequent comorbidities were allergic rhinitis (38.9%) and asthma (19.2%). In the subgroup with prior psychological or psychiatric care, the proportion of patients who remained in follow-up declined after initiating dupilumab. Among those with previous psychological consultations (n=124), 64.5% continued follow-up during the treatment period (p<0.0001), despite an increase in the median number of visits [from 1(IQR:1-2) to 2(IQR:1-3)]. Among patients with prior psychiatric care (n = 62), only 48.4% maintained follow-up (p<0.0001), with a stable median number of visits [2(IQR:1-3) in both periods]. Psychiatric emergency visits were infrequent. In all patients with a personal history, recurrence was observed during follow-up. No new cases of recurrent depressive disorder or phobic anxiety disorder were identified.
CONCLUSIONS: Initiation of dupilumab in patients with AD and prior mental health care was associated with reduced follow-up needs of psychologic and psychiatric care. These findings suggest a potential stabilizing effect on mental health and improved overall disease management in real-world settings.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE529
Topic
Economic Evaluation, Epidemiology & Public Health, Study Approaches
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies, Work & Home Productivity - Indirect Costs
Disease
Biologics & Biosimilars, No Additional Disease & Conditions/Specialized Treatment Areas