OBJECTIVES: Prurigo nodularis (PN) is a chronic, inflammatory skin disease characterized by intense itch. Little evidence exists on the burden of PN in Italy. This real-world analysis aimed to investigate the healthcare resource consumption and related direct costs of patients hospitalized for PN and the prevalence of associated comorbidities.

METHODS: The analysis utilized the administrative databases of healthcare units that cover approximately 12 million inhabitants across Italy. Adult patients were included by ICD-9-CM=698.3 (lichen simplex chronicus; neurodermatitis circumscripta; PN) as proxy of PN diagnosis, from 01/2010-09/2021, and had 1 year of data availability before (baseline) and after (follow-up) hospitalization (index date). These patients were 1:2 matched by age, sex, and index date (year) to adults without such hospitalization (matched non-PN controls).

RESULTS: The analysis comprised 295 PN-hospitalized patients, matched with 590 non-PN individuals (mean age 63.2 years, 56.3% male). At baseline, patients had a greater comorbidity burden than non-PN controls, including higher prevalence of hypertension (56.6% vs 36.6%, respectively), dyslipidemia (26.4% vs 18.0%), diabetes (24.4% vs 12.5%) and mental health conditions (14.9% vs 7.8%). During 1-year follow-up, PN-hospitalized patients had significantly higher resource consumption than matched controls, in terms of mean number of prescriptions for drugs used in PN (5.1 vs 1.9, p-value<0.001), other drugs (11.7 vs 6.5, p-value<0.001), all-cause hospitalization (1.4 vs 0.1, p-value<0.001) and outpatient services (5.4 vs 2.5, p-value<0.001). Mean annual all-cause healthcare costs for patients over 1-year follow-up were €3,847 total (€875 drugs, €2,652 hospitalization, €320 outpatient services), higher than those for the matched controls, of €711 total (p-value<0.001) (€353 drugs, €228 hospitalization, €130 outpatient services).

CONCLUSIONS: Patients hospitalized for PN had a higher comorbidity burden at baseline and greater healthcare resource consumption during 1-year follow-up compared to matched controls, with a 6-fold increase in all-cause healthcare costs, indicating substantial clinical burden and remaining unmet need in these patients.