OBJECTIVES:

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that is characterized by high symptom burden due to recurrent painful lesions under the skin, requiring frequent healthcare encounters. We investigated the economic burden of HS in the USA by evaluating healthcare resource utilization (HCRU) and associated costs.

METHODS:

This retrospective cohort study using MarketScan (commercial, Medicare and Medicaid populations) claims data included all patients diagnosed with HS before 2017. All-cause and HS-related HCRU (rate per 1,000 patient-years [kPY]) and related costs in 2017 are presented, stratified by obesity and disease severity, using two separate proxies: history of biologic medication and history of in/outpatient HS-specific surgery.

RESULTS:

The mean age of the 54,912 patients was 40.0 years (24.3% male; 2.8% history of biologic medication; 16.4% history of HS-specific surgery). More severe patients were more often obese, had more comorbidities, and used more HS-related medication. On average, there were 726.8 HS-related outpatient claims per kPY (3.9% of all-cause outpatient claims). The rate ratio among outpatient claims was 1.6 for obesity/no obesity, 6.1 for biologic/no biologic and 3.5 for surgery/no surgery. Compared to outpatient claims, rates of emergency department (14.4 per kPY) and inpatient claims (2.7 per kPY) were much lower (each 1.7% of the all-cause claims); however, rates for both were 5–12 times higher in patients with severe disease. 81.7% of patients used HS-related medication (including biologics) and 94.3% of HS-related claims were for medication, covering 48.4% of all-cause medication claims and 88.2% of HS-related healthcare costs.

CONCLUSIONS:

There is considerable variation in HCRU and costs in patients with HS, partly driven by disease severity. Most resource utilization occurs with medication and in the outpatient setting. The high proportion of non-HS-related resources in most patients points to an important comorbidity burden in this patient population.