All-cause health care resource utilization and costs among adults with alopecia areata: A retrospective claims database study in the United States

Mostaghimi, Arash; Gandhi, Kavita; Done, Nicolae; Ray, Mark; Gao, Wei; Carley, Christopher; Wang, Travis; Swallow, Elyse; Sikirica, Vanja

doi:10.18553/jmcp.2022.28.4.426

Cited by 12 publications

(21 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Evidence regarding the epidemiology of AA and AT/AU in the US remains limited, despite a known clinical, economic, and humanistic burden of disease . Using recent data from a large, nationally representative US ESI population, this population-based cohort study found that AA prevalence was within the range of clinician-adjudicated estimates for the general US population, while AA incidence was higher than previous estimates obtained in US clinical settings .…”

Section: Discussionmentioning

confidence: 67%

See 1 more Smart Citation

Trends in Prevalence and Incidence of Alopecia Areata, Alopecia Totalis, and Alopecia Universalis Among Adults and Children in a US Employer-Sponsored Insured Population

et al. 2023

Self Cite

View full text Add to dashboard Cite

ImportanceAlopecia areata (AA) is characterized by nonscarring hair loss of the scalp, face, and/or body. Alopecia totalis (AT) and alopecia universalis (AU) involve complete loss of the scalp and body hair, respectively. The epidemiology of AA in the US remains unclear, having previously been extrapolated from older studies that were limited to specific geographic areas or clinical settings, or from self-reported data.ObjectiveTo estimate the annual prevalence and incidence of AA and AT and/or AU (AT/AU) in the US.Design, Setting, and ParticipantsThis retrospective, population-based cohort study was conducted from January 2016 to December 2019 and included enrollees in the IBM MarketScan Commercial Claims and Encounters and Medicare Supplemental databases and their dependents, with plan enrollment during each study calendar year and the year prior.ExposuresPrevalent cases were identified by 1 or more claims for AA or AT/AU (International Statistical Classification of Diseases, Tenth Revision, Clinical Modification [ICD-10-CM] codes L63.x, L63.0, L63.1) during each year of interest or the year prior. Incident cases were identified by 1 or more claims for AA or AT/AU during a specific year and no diagnosis the year prior.Main Outcomes and MeasuresAnnual incidence and prevalence rates were calculated and stratified by age, sex, and region. National employer-sponsored insurance population estimates were obtained using population-based weights.ResultsAmong eligible patients (2016: n = 18 368 [mean (SD) age, 40.6 (17.9) years; 12 295 women (66.9%)]; 2017: n = 14 372 [mean (SD) age, 39.6 (17.7) years; 9195 women (64.0%)]; 2018: n = 14 231 [mean (SD) age, 38.9 (17.3) years; 8998 women (63.2%)]; 2019: n = 13 455 [mean (SD) age, 39.1 (17.4) years; 8322 women (61.9%)]), AA prevalence increased from 0.199% (95% CI, 0.198%-0.200%) in 2016 to 0.222% (95% CI, 0.221%-0.223%) in 2019. Roughly 5% to 10% of prevalent and incident cases of AA were AT/AU. The prevalence of AT/AU increased from 0.012% (95% CI, 0.012%-0.013%) to 0.019% (95% CI, 0.018%-0.019%) from 2016 to 2019. Incidence of AA per 100 000 person-years ranged from 87.39 (95% CI, 86.84-87.96) in 2017 to 92.90 (95% CI, 92.35-93.45) in 2019. Incidence of AT/AU ranged from 7.09 (95% CI, 6.94-7.25) in 2017 to 8.92 (95% CI, 8.75-9.09) in 2016. Prevalence and incidence of AA and AT/AU were higher among female vs male individuals, adults vs children and adolescents, and in the Northeast vs other regions.Conclusions and RelevanceThe results of this cohort study suggest that these recent AA prevalence and incidence estimates could help improve current understanding of the disease burden. Further research is warranted to elucidate subpopulation differences and trends in AA in the broader US population.

show abstract

Section: Discussionmentioning

confidence: 67%

“…Although many patients with AA recover within the first year, an estimated 4.5% to 36.1% of patients may ultimately progress to develop AT and/or AU (AT/AU) . Living with AA can be associated with reduced quality of life, social functioning, and psychological well-being, with substantial costs to patients and health care systems …”

Section: Introductionmentioning

confidence: 99%

Trends in Prevalence and Incidence of Alopecia Areata, Alopecia Totalis, and Alopecia Universalis Among Adults and Children in a US Employer-Sponsored Insured Population

et al. 2023

Self Cite

View full text Add to dashboard Cite

show abstract

“…Most (65.1%) patients worried about being unable to afford hairpieces/wigs 41 . Other studies concurred similar estimates of out‐of‐pocket costs, ranging from $500 USD to $3300 USD per year 18,65,66 and reaching as high as $5000 USD monthly, if off‐label drugs were prescribed as they were not covered by insurance companies 36 …”

Section: Resultsmentioning

confidence: 69%

“…66 The out-of-pocket costs were higher with AT/AU. 65 The majority of patients were seriously (25.2%) or moderately (31.7%) affected by the financial burden. 66 In addition, the annual cost of buying hair pieces/wigs and receiving psychotherapy to manage the hair loss averaged $2000 USD per year.…”

Section: Financial Burdenmentioning

confidence: 99%

The burden of alopecia areata: A scoping review focusing on quality of life, mental health and work productivity

Muntyanu

Gabrielli

Donovan

et al. 2023

Acad Dermatol Venereol

View full text Add to dashboard Cite

Alopecia areata (AA) is a common inflammatory autoimmune disease of the hair which can have a significant negative impact on quality of life (QoL), mental health and productivity. The aim of this scoping review is to elucidate the burden of AA focusing on these three realms. Inclusion criteria included all original manuscripts with no restriction on study type or statistical method written in English (or having an English abstract). For QoL 40 articles were included, 85 for psychiatric comorbidities, and 9 for work/school absenteeism/presenteeism mostly consisting of cross‐sectional and observational cohort studies. QoL impairment was detected in over 75% of patients and up to one‐third reported extremely severe QoL impairments. Specific QoL dimensions with the greatest impact were embarrassment, social functioning, as well as shopping and/or housework. Cross‐sectional studies assessing the psychological burden of adult patients with AA found that the presence of signs of anxiety and/or depression ranged from 30% to 68% and affected all age groups. Rates of work absenteeism and unemployment were significantly higher in AA patients compared to healthy controls. Up to 62% reported making major life decisions including relationships, education and career based on their AA. Additionally, the extensive camouflage techniques and time lost from work led to a strong financial burden for patients and the numerous physician visits added to the healthcare costs. The overall impact of AA stretches much further than simply being an aesthetic concern and can negatively impact every part of an individual's life. An individualized approach and effective treatments will help reduce the psychosocial consequences and distress and return patients to their normal state of health.

show abstract

“…In the online survey study cited previously, 4 of 19 patients with AA were clinician-adjudicated as having AT or AU, which resulted in a population prevalence of 0.04% for combined AT and AU . In a recent analysis of the IBM MarketScan insurance claims database, 8.3% of adults with AA were diagnosed with AT or AU . Three of 26 total patients with AA identified in the first NHANES survey in the United States were diagnosed as having AT or AU …”

Section: Discussionmentioning

confidence: 99%

Overall and Racial and Ethnic Subgroup Prevalences of Alopecia Areata, Alopecia Totalis, and Alopecia Universalis

Mastacouris

Strunk

et al. 2023

JAMA Dermatol

View full text Add to dashboard Cite

ImportancePrevalences of alopecia areata (AA), alopecia totalis (AT), and alopecia universalis (AU) are poorly established.ObjectiveTo estimate overall and subgroup prevalences of AA and its subtypes.Design, Setting, and ParticipantsThis cross-sectional study using electronic records comprising the Explorys database (Watson Health, IBM Corporation) included children, adolescents, and adults seeking healthcare across the 4 census regions in the US between January 1, 2019, and December 31, 2019. The statistical analysis was conducted between July 21, 2022, and December 22, 2022.Main Outcomes and MeasuresPrevalent cases of AA, AT, and AU.ResultsOf the 1 093 176 patients who met inclusion criteria, 1812 had at least 1 code for AA, 1216 female (67%) and 596 male (33%) patients. Overall age-and-sex standardized prevalences among adults and among children and adolescents were observed to be 0.18% and 0.10%, respectively. The age-standardized prevalence ratio in women to men was 1.32. Standardized prevalence was highest in those aged 30 to 39 (297 per 100 000; 95% CI, 263-335) and 40 to 49 (270 per 100 000; 95% CI, 240-303) years. The highest standardized prevalence was observed among Asian patients (414 per 100 000; 95% CI, 306-548), followed by patients reporting another race or multiple races (314 per 100 000; 95% CI, 266-368), Black (226 per 100 000; 95% CI, 199-255), and Hispanic/Latino (212 per 100 000; 95% CI, 129-328) patients. White patients had the lowest standardized prevalence (168 per 100 000; 95% CI, 157-179) among racial and ethnic subgroups. Relative to White patients, standardized prevalence ratios for Asian, Black, and Hispanic/Latino patients were 2.47 (95% CI, 2.17-2.81), 1.35 (95% CI, 1.26-1.44), and 1.26 (95% CI, 1.03-1.55), respectively. Cases of AT and AU comprised approximately 9% of patients diagnosed with AA.Conclusions and RelevanceThe findings of this cross-sectional study suggest that there is a significant burden of AA, AT, and AU in the US in which people of color, particularly Asian Americans, appear to be disproportionately affected.

show abstract

All-cause health care resource utilization and costs among adults with alopecia areata: A retrospective claims database study in the United States

Cited by 12 publications

References 28 publications

Trends in Prevalence and Incidence of Alopecia Areata, Alopecia Totalis, and Alopecia Universalis Among Adults and Children in a US Employer-Sponsored Insured Population

Trends in Prevalence and Incidence of Alopecia Areata, Alopecia Totalis, and Alopecia Universalis Among Adults and Children in a US Employer-Sponsored Insured Population

The burden of alopecia areata: A scoping review focusing on quality of life, mental health and work productivity

Overall and Racial and Ethnic Subgroup Prevalences of Alopecia Areata, Alopecia Totalis, and Alopecia Universalis

Contact Info

Product

Resources

About