HEALTHCARE RESOURCE UTILISATION AND COSTS ASSOCIATED WITH BULLOUS PEMPHIGOID IN ENGLAND: A RETROSPECTIVE MATCHED COHORT STUDY
Author(s)
Emma Benton, MD1, Philip Hampton, MD2, Lisa SUTOUR, PharmD, MSc3, Danielle L Isaman, MS3, Anastasia Petrova, PhD4, Marie Fournier, MSc5, Ellen Hubbuck, MSc6, Leah Fisher, PhD6, Aron Buxton, BSc6, Andreas Kuznik, PhD7, Wenzhen Ge, PhD7, Marine Payan, PharmD, MSc8.
1St John's Institute of Dermatology, London, United Kingdom, 2Department of Dermatology, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom, 3Sanofi, Cambridge, MA, USA, 4Sanofi, Reading, United Kingdom, 5Sanofi, Gentilly, France, 6Human Data Sciences, Cardiff, United Kingdom, 7Regeneron Pharmaceuticals Inc, Tarrytown, NY, USA, 8Sanofi, Amsterdam, Netherlands.
1St John's Institute of Dermatology, London, United Kingdom, 2Department of Dermatology, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom, 3Sanofi, Cambridge, MA, USA, 4Sanofi, Reading, United Kingdom, 5Sanofi, Gentilly, France, 6Human Data Sciences, Cardiff, United Kingdom, 7Regeneron Pharmaceuticals Inc, Tarrytown, NY, USA, 8Sanofi, Amsterdam, Netherlands.
OBJECTIVES: Bullous pemphigoid (BP) is a rare, predominantly autoimmune subepidermal blistering disorder requiring long-term management. This study assessed the real-world healthcare resource utilisation and costs of BP in England.
METHODS: This retrospective cohort study used data from Clinical Practice Research Datalink (CPRD) Aurum linked to Hospital Episode Statistics (HES). Patients diagnosed with BP between 2014-2018 were 1:2 propensity score matched to non-BP controls on calendar year, age, gender, ethnicity, Index of Multiple Deprivation and select comorbidities. Patients were followed from first observed diagnosis of BP (index date) for one year or until death, if earlier. Those with incomplete follow-up due to censoring on last practice data collection date or HES scheme end date were excluded from the analysis. All-cause healthcare contacts and costs were summarized per patient-year (PPY). Generalized linear models estimated incidence rate ratios (IRR) between BP patients and non-BP controls.
RESULTS: A total of 3,976 patients with BP and 8,058 matched non-BP controls were analysed. Mean age was 79 years and 52.6% were female. Healthcare utilization was significantly higher in BP patients across all settings, including inpatient admissions (1.78 vs 0.80 PPY; IRR: 2.53), Accident and Emergency attendances (1.42 vs 0.63 PPY; 2.43), outpatient visits (10.17 vs 4.53 PPY; 2.26), primary care visits (24.84 vs 13.90 PPY; 1.86), and prescriptions (132.22 vs 81.00 PPY; 1.66). Among hospitalized patients, total inpatient length of stay was more than doubled (24.33 vs 11.25 days PPY). Healthcare contact costs were significantly higher across all settings, with total costs at £7,757 for BP patients and £3,069 for non-BP controls.
CONCLUSIONS: BP is associated with a substantial burden on healthcare systems, with 2.5-fold higher direct medical costs and doubled total inpatient length of stay compared to matched controls. These findings highlight the need for safer long-term management strategies to reduce hospitalizations and minimize healthcare resource utilization.
METHODS: This retrospective cohort study used data from Clinical Practice Research Datalink (CPRD) Aurum linked to Hospital Episode Statistics (HES). Patients diagnosed with BP between 2014-2018 were 1:2 propensity score matched to non-BP controls on calendar year, age, gender, ethnicity, Index of Multiple Deprivation and select comorbidities. Patients were followed from first observed diagnosis of BP (index date) for one year or until death, if earlier. Those with incomplete follow-up due to censoring on last practice data collection date or HES scheme end date were excluded from the analysis. All-cause healthcare contacts and costs were summarized per patient-year (PPY). Generalized linear models estimated incidence rate ratios (IRR) between BP patients and non-BP controls.
RESULTS: A total of 3,976 patients with BP and 8,058 matched non-BP controls were analysed. Mean age was 79 years and 52.6% were female. Healthcare utilization was significantly higher in BP patients across all settings, including inpatient admissions (1.78 vs 0.80 PPY; IRR: 2.53), Accident and Emergency attendances (1.42 vs 0.63 PPY; 2.43), outpatient visits (10.17 vs 4.53 PPY; 2.26), primary care visits (24.84 vs 13.90 PPY; 1.86), and prescriptions (132.22 vs 81.00 PPY; 1.66). Among hospitalized patients, total inpatient length of stay was more than doubled (24.33 vs 11.25 days PPY). Healthcare contact costs were significantly higher across all settings, with total costs at £7,757 for BP patients and £3,069 for non-BP controls.
CONCLUSIONS: BP is associated with a substantial burden on healthcare systems, with 2.5-fold higher direct medical costs and doubled total inpatient length of stay compared to matched controls. These findings highlight the need for safer long-term management strategies to reduce hospitalizations and minimize healthcare resource utilization.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE35
Topic
Economic Evaluation, Study Approaches
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Geriatrics, Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)