Patient characteristics associated with all-cause healthcare costs of alopecia areata in the United States

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

doi:10.1080/13696998.2023.2188843

Cited by 2 publications

(2 citation statements)

References 18 publications

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“…30 Another study, published in 2023, reported that patients with AA who had at least 1 Charlson Comorbidity Index comorbidity, vs those who did not, had 104.4% higher medical costs. 31 Overall, our study emphasizes the persistent unmet needs of patients with AA and the importance of studying the collective burden of AA and its comorbidities because their combination may have a worse impact than any one disease alone. Because AA and many of these comorbidities share underlying signaling pathways, 18 it is not unreasonable to think effec-tive and tolerable treatment could address multiple disordersthat is, AA and various comorbidities-simultaneously.…”

Section: Discussionmentioning

confidence: 67%

“…The elevated cost is thought to be at least partially due to comorbidities associated with AA, including hyperlipidemia, hypertension, thyroid disorders, depression, and anxiety . Another study, published in 2023, reported that patients with AA who had at least 1 Charlson Comorbidity Index comorbidity, vs those who did not, had 104.4% higher medical costs …”

Section: Discussionmentioning

confidence: 99%

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Immune-Mediated and Psychiatric Comorbidities Among Patients Newly Diagnosed With Alopecia Areata

Mostaghimi,

Soliman,

et al. 2024

JAMA Dermatol

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ImportanceAlopecia areata (AA) has been associated with multiple comorbidities, yet information regarding the timing of comorbidity development after AA diagnosis is limited.ObjectiveTo evaluate the prevalence and new-onset incidence of psychiatric and autoimmune comorbidities in patients with AA in the US.Design, Setting, and ParticipantsThis retrospective cohort analysis used data collected from January 1, 2007, to April 30, 2023, from the Merative MarketScan Research Databases, which contains medical and drug claims data from more than 46 million patients in the US. Data from adolescent and adult patients (aged 12-64 years) diagnosed with AA and patients without AA (ie, controls) were evaluated. For some analyses, patients with AA were matched (1:4) to controls based on sex, age, and geographic region.Main Outcomes and MeasuresPrevalence (at the time of AA diagnosis) and incidence (new onset after AA diagnosis) of psychiatric and autoimmune diseases were reported as percentage of patients. Risk of developing a new-onset psychiatric or autoimmune disease after AA diagnosis was calculated as adjusted hazard ratios (AHRs) with 95% CIs.ResultsAt baseline, 63 384 patients with AA and 3 309 107 without AA were identified. After matching, there were 16 512 and 66 048 patients in the AA and control groups, respectively, with a mean (SD) age of 36.9 (13.4) years and 50.6% of whom were female. Compared with the unmatched controls, patients with AA had higher prevalence of psychiatric (30.9% vs 26.8%; P &lt; .001) and autoimmune (16.1% vs 8.9%; P &lt; .0001) comorbidities at AA diagnosis; incidence was also higher in patients with AA (without history of these comorbidities) vs the matched control group. Patients with AA vs controls had a significantly higher risk of developing a psychiatric (AHR, 1.3; 95% CI, 1.3-1.4) or autoimmune (AHR, 2.7; 95% CI, 2.5-2.8) comorbidity.Conclusions and RelevanceIn this cohort study, patients with AA had a higher prevalence of autoimmune and psychiatric comorbidities at AA diagnosis and demonstrated an elevated risk of new-onset autoimmune and psychiatric comorbidities after their diagnosis. These data highlight the most common comorbidities among patients with AA and may help physicians counsel and monitor patients newly diagnosed with AA.

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Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Immune-Mediated and Psychiatric Comorbidities Among Patients Newly Diagnosed With Alopecia Areata

Mostaghimi,

Soliman,

et al. 2024

JAMA Dermatol

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A retrospective analysis of disease epidemiology, comorbidities, treatment patterns, and healthcare resource utilization of alopecia areata in the United Arab Emirates using claims database

Hammadi,

Parmar,

Farghaly

et al. 2024

The Journal of Dermatology

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Alopecia areata (AA) is an autoimmune disorder that manifests as nonscarring hair loss and imposes a substantial disease burden. The current study, using an e‐claims database, assesses the disease burden, comorbidities, treatment patterns, specialties involved in the diagnosis of AA, healthcare resource utilization (HCRU), and associated costs in privately insured patients with AA in Dubai, United Arab Emirates. The retrospective longitudinal secondary study was conducted using Dubai Real‐World Database e‐claims data during 01 January 2014 to 30 June 2022. Patients with at least one diagnosis claim of AA during the index period (01 January 2015–30 June 2021) with continuous enrollment (one or more AA/non‐AA claim in the post‐index period) were included in the analysis. The patients were stratified into subcohorts based on diagnosis code and treatment patterns, as mild, moderate‐to‐severe, and others. Demographics, comorbidities, treatment patterns, specialists visited, and HCRU were assessed. The study included 11 851 patients with AA (mean age: mild: 37 years; moderate‐to‐severe: 36 years), with a male predominance (mild: 77.6%; moderate‐to‐severe: 60.8%). The most prevalent comorbidities in the moderate‐to‐severe AA subcohort were autoimmune and T‐helper 2–mediated immune disorders, including contact dermatitis and eczema (62.1%), atopic dermatitis (36.1%), and asthma (36.1%). Most patients consulted dermatologists for treatment advice (mild AA: 87.4%; moderate‐to‐severe AA: 47.7%) and, notably, within 1 day of AA diagnosis. Topical steroids were frequently prescribed across cohorts, regardless of disease severity. Analysis of comorbidities among patients with AA indicated an additional HCRU burden among these subsets of patients. The median disease‐specific HCRU cost was higher for psychological comorbidities versus autoimmune and T‐helper 2–mediated immune disorders (US $224.99 vs US $103.70). There is a substantial disease and economic burden in patients with AA and associated comorbid conditions; therefore, investing in novel therapies that target the underlying autoimmune pathway may address the gap in effective management of AA.

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Patient characteristics associated with all-cause healthcare costs of alopecia areata in the United States

Cited by 2 publications

References 18 publications

Immune-Mediated and Psychiatric Comorbidities Among Patients Newly Diagnosed With Alopecia Areata

Immune-Mediated and Psychiatric Comorbidities Among Patients Newly Diagnosed With Alopecia Areata

A retrospective analysis of disease epidemiology, comorbidities, treatment patterns, and healthcare resource utilization of alopecia areata in the United Arab Emirates using claims database

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