OBJECTIVES To investigate healthcare resource utilization and direct medical costs, and explore their associated factors among Chinese chronic urticarial (CU) patients.

METHODS This is a retrospective observational study based on the China Health Insurance Research Association Claims Database (CHIRA). Adult patients with a primary diagnosis of CU identified by ICD-10 supplemented by Chinese description between Jan-Jun in 2017 were included. Drug utilization, hospitalization, outpatient visit, and medical costs were identified within 6 months after the first qualified diagnosis of eligible patients (defined as index event). Generalized linear models were used to explore the impact factors on cost and medical resource utilization, respectively.

RESULTS A total of 2,829 CU patients (45.5±18.7, 55.1% female) were included. Most patients (79.4%) received non-sedating 2nd-generation H1-antihistamines with the most frequent prescription of Loratadine (27.5%). Nearly all patients (96.0%) received CU-related outpatient service with an average of 3.5 visits and 983.6 CNY per patient with 70.0% attributable to medical cost during follow-up. Chinese herbal medicine cost took up the highest proportion (42.4%) of outpatient medical cost. 4.7% patients had CU-related hospitalization with an average of 1.2 visit. The mean length of stay was 11.7 days and the average cost was 7510.4 CNY per patient. Patients in 1^st-tier ,2^nd-tier cities had higher costs than patients in 4^th-7^th-tier cities (729.2, 582.9 vs. 249.7, P<0.05) and more outpatient visiting (5.0, 4.0 vs 2.0, P<0.05), while patients in east China had lower costs (551.4 Vs 261.8, P<0.05) but more outpatient visiting (4.0 Vs 2.0, P<0.05) than patients in middle/west.

CONCLUSIONS : Non-sedating 2nd-generation H1-antihistamines are the most commonly used drugs to treat CU consisting of a guideline. Though CU is mainly consumed outpatient service, the inpatient cost would be heavy once being hospitalized. Patients in tier 1,2 cities are associated with higher cost and more outpatient visiting, the reason should be clarified with further study.