Out-of-Pocket Costs in Alopecia Areata: A Cross-Sectional Study in German-speaking Countries

Abstract

Alopecia areata is a common skin disease which is associated with psychosocial and financial burden. No curative therapy exists and, hence, affected persons resort to self-financed cosmetic solutions. However, studies on the economic impact of alopecia areata on individuals are limited. To estimate annual individual out-of-pocket costs in persons with alopecia areata, a cross-sectional study using a standardized online questionnaire was performed in Germany, Austria and Switzerland. A total of 346 individuals (95.1% women, mean age: 38.5 ± 11.6 years) with alopecia areata participated between April and August 2020. Mean additional spending on everyday necessities was 1,248€ per person per year, which was significantly influenced by the duration of the illness, the treatment provider, and disease severity. Hair replacement products and cosmetics accounted for the highest monthly costs, followed by costs for physician visits, hospital treatments, and medication. Most participants (n = 255, 73.7%) were currently not undergoing treatment, due to lack of efficacy, side-effects, costs and acceptance of the disease. Sex differences in expenses were observed, with women having higher expenditures. Alopecia areata-related out-of-pocket costs place a considerable financial burden on affected individuals, are higher compared with those of other chronic diseases, and should be considered in economic assessments of the impact of this disease.

The financial burden of alopecia: a survey study

“…The financial burden of alopecia is underexplored in the literature, with most studies focusing on alopecia areata. 2,3,5 We found that individuals diagnosed with alopecia experience additional financial costs for treating or concealing their condition. Higher out-of-pocket expenses arose from initially seeking nondermatologist providers, purchasing OTC products, and utilizing camouflaging agents, such as cranial prostheses.…”

“…Alopecia, an often chronic hair loss condition, impacts individuals' self-identity, psychological well-being, and quality of life, and may incur considerable financial costs. [1][2][3][4] Patients frequently turn to alternative therapies, such as over-the-counter (OTC) products, camouflaging agents, or cranial prostheses. [1][2][3] This study explores the financial burden experienced by alopecia patients.…”

“…[1][2][3][4] Patients frequently turn to alternative therapies, such as over-the-counter (OTC) products, camouflaging agents, or cranial prostheses. [1][2][3] This study explores the financial burden experienced by alopecia patients.…”

Peer-Recommended Coping Strategies for Individuals Living With Alopecia Areata

“…Alopecia areata (AA) is a chronic immunological condition characterized by hair loss on the scalp and/or body. The effectiveness of medical treatments for AA is inconsistent and unpredictable (Strazzulla et al, 2018), and in many instances, insurers are unwilling to reimburse for the cost of treatments and psychosocial coping modalities (e.g., Ezemma et al, 2023; Kullab et al, 2023) as AA has traditionally been recognized as a medically benign, cosmetic condition. However, an “it’s just hair” perspective fails to consider the elevated levels of suffering and significant impact on quality of life (QOL) reported by many living with AA (Rencz et al, 2016).…”

Wigs and Alopecia Areata: Psychosocial Impact and Economic Considerations

“…A third cross-sectional study utilizing a standardized online survey was conducted in Germany, Austria, and Switzerland [37]. It was completed by 346 AA patients (95.1% women, mean age 38.5 ± 11.6 years) and showed that average extra spending on daily essentials was EUR 1248 per person annually.…”