The cost of childhood atopic dermatitis in a multi‐ethnic Asian population: a cost‐of‐illness study

Abstract

Summary Background Childhood atopic dermatitis can often have a negative impact on quality of life for affected children and their caregivers. The condition contributes to increased healthcare costs and can pose heavy economic burdens on healthcare systems and societies. Objectives The objective of this study is to provide a comprehensive estimate of the economic burden of childhood atopic dermatitis in a Singaporean sample and to investigate associated factors. Methods This cross‐sectional cost‐of‐illness study applied a societal perspective. Data was collected between December 2016 and December 2017 in Singapore. Caregivers to children below 16 years of age with a physician‐confirmed diagnosis of atopic dermatitis were recruited and sociodemographics, clinical characteristics, health service utilization data and time spent on caregiving were collected from all eligible participants. Results The average annual cost per child with atopic dermatitis was estimated at U.S. dollars (USD) 7943 (mild USD 6651, moderate USD 7935 and severe USD 14 335) in 2017 prices. The major cost was for informal caregiving (46% of the total cost) followed by out‐of‐pocket expenses (37%). Healthcare utilization contributed to 17% of the total cost of which 43% was for medications. Conclusions Childhood atopic dermatitis imposes substantial costs with a large proportion arising from informal caregiving and out‐of‐pocket expenses. The costs related to atopic dermatitis are also strongly related to disease severity. This information is important for policy makers and other health planners when considering how to better support affected families. What's already known about the topic? Childhood atopic dermatitis is a costly disease for society. However, comprehensive cost estimations are lacking. Previous cost studies are old, based on small sample sizes or are healthcare‐setting specific. What does this study add? This study comprises a health economic evaluation assessing different levels of care and includes various categories of costs. The result showed that informal caregiving was the most prominent cost for children with atopic dermatitis.

The global burden of atopic dermatitis: lessons from the Global Burden of Disease Study 1990–2017*

“…Similar cost estimates have been published for AD in Singapore, 16 the Asia Pacific region, Thailand, South Korea and Vietnam 17 . Understandably, cost increases with disease severity 12,14,16 …”

Atopic dermatitis: economic burden and strategies for high‐quality care

“…The study showed that the economic burden of childhood AD is mostly attributed to informal caregiving (personal care, preparing special meals and providing emotional support) and out‐of‐pocket expenses (purchased products such as moisturizing creams and hygiene products, and laundry costs) . The study findings suggest the need for policies to reduce the burden of informal caregiving and financial strain on families . Some aspects of caregiving can be aided by a range of supportive services to meet the holistic needs of patients and carers, including psychological support, access to social workers and occupational therapy .…”

“…AD, characterized by symptoms of itchiness, sleep disturbances, pain, physical changes to the skin, anxiety and loss of productivity (through absenteeism), is associated with a marked impairment of quality of life . The condition often requires regular application of moisturizers, avoidance of triggering factors, out‐of‐pocket expenses and informal caregiving (for children and the elderly) . In more severe cases, regular visits to specialist centres (for phototherapy or drug monitoring), attendance in the emergency department and inpatient admission may be required .…”

“…In this issue of the BJD , Olsson et al . provide a comprehensive estimate of the economic burden of childhood AD in Singapore by assessing healthcare cost, cost for informal caregiving and other family expenses . The study showed that the economic burden of childhood AD is mostly attributed to informal caregiving (personal care, preparing special meals and providing emotional support) and out‐of‐pocket expenses (purchased products such as moisturizing creams and hygiene products, and laundry costs) .…”

Lifelong Impact of Severe Atopic Dermatitis on Quality of Life: A Case Report

“…Although it is difficult to quantify the full economic burden of AD, the indirect costs of atopic diseases can exceed direct costs [3]. Several studies have attempted to quantify the QoL and direct/indirect economic burden of AD [3][4][5][6]. However, these estimates may not capture the more intangible disease-related burden and associated economic burden.…”