OBJECTIVES: To investigate the real-world treatment pattern and direct medical costs among patients with atopic dermatitis (AD) in China.

METHODS: Data were obtained from Tianjin Urban Employee Basic Medical Insurance database. Adult patients with ≥1 claim with a primary diagnosis of AD (ICD-10 codes L20.x) were identified between January 1, 2015 and December 31, 2016, and followed over 12 months. Treatment pattern was assessed by treatment rate, treatment therapies used within 3-month intervals, and persistence duration calculated based on time spent on therapy without a gap of ≥90 days. AD-specific direct medical costs and their composition were estimated during the follow-up period. Subgroup analysis was conducted, where included patients were further divided into treatment-naïve and previously-treated patients according to the presence of AD-related prescriptions during the 6-month pre-index (baseline).

RESULTS: 1,785 AD patients (mean age 46.4 ± 14.8 years, 55.6% female) were included. 96.4% patients received ≥1 AD-related prescriptions during the follow-up period, with treatment rate decreasing from 94.1% at 3 months to 22.9% at 12 months after index. Persistent duration was estimated to be 51.9±72.29 days. Topical treatment was the most common therapy (88.5%), followed by Chinese patent medicine (36.8%), systemic treatment (34.4%), wet therapy (18.9%) and phototherapy (3.6%). AD-specific cost was ¥1,212±¥3,551, and medication cost was the most important cost component for AD patients (56.4%), followed by treatment (18.4%) and examination costs (18.0%). Previously-treated patients (n=877) had longer persistent duration (65.4±82.6 vs. 38.8±57.6 days, P<0.001) and higher costs (¥1,610±¥4,068 vs. ¥828±¥2,918, P<0.001) compared to treatment-naïve patients (n=908).

CONCLUSIONS: Poor treatment persistence and declined treatment rates were observed among Chinese patients with AD, which indicates that effective strategies are needed for better long-term management of AD.