OBJECTIVES:

Out-of-pocket expenses correspond to what patients must pay after reimbursements from basic and additional social insurance organisations have been deducted. We evaluated these costs for patients with prurigo nodularis (PN) in France.

METHODS:

A self-administered questionnaire was disseminated to adult patients members of the ‘Association France Prurigo Nodulaire’ and to PN patients who consulted in 3 hospitals [Brest-Lyon-Toulouse].

Pruritus severity was assessed by the patients using 5D-itch-scale Score.

Questions about medical and non-medical resources used over the last 6 months were also included.

RESULTS:

141 subjects answered the questionnaire, a significant sample for a disease with a low reported prevalence. Average age was 56 years and almost 60% were women. Two-thirds (68%) of the respondents reported living with a partner.

According to 5D-itch-scale, 64.5% reported 6 or more itchy areas. Itching was most frequent on the chest (68%), forearms (68%), arms (63%), buttocks (60%), back (58%) and face (59%). 105 (74.5%) reported at least one cutaneous lesion on a visible body area.

94% [n=132] reported out-of-pocket expenses related to PN.

Average annual out-of-pocket expenses per patient were €855±769 [median €605].

This amount increased with pruritus severity : from €298±267 [median €202] for the least severe (1st quartile) to €1467±1237 [median €922] for the most severe (4th quartile). A linear regression illustrated that an additional point on the 5D-itch-scale score consequently increased out-of-pocket expenses by €75. [p<0.0001].

Similarly, there were significantly higher out-of-pocket expenses for patients reporting an affected visible area: €992±802 [median €802] compared to patients without a visible lesion: €444±471 [median €296].

CONCLUSIONS:

Out-of-pocket expenses of PN are significantly higher in patients with severe pruritus compared with milder forms of pruritus.

The economic impact of PN can be significant for patients and overall costs must be considered in PN disease management.

Further investigation into the economic burden from the patient perspective is necessary.