Economic burden and healthcare resource utilization of childhood atopic dermatitis in China

doi:10.5246/jcps.2024.05.035

Abstract

Abstract:

The primary objective of this study was to estimate the costs and healthcare resource utilization (HCRU) associated with atopic dermatitis (AD) in Chinese pediatric patients and to investigate the factors contributing to the costs of AD. This cross-sectional study employed a convenience sampling approach, with patient-level data obtained from a nationwide survey conducted across 31 provinces in China between February and March of 2022, utilizing an internet-based questionnaire. Caregivers of children under 18 years old with a physician-confirmed diagnosis of atopic dermatitis were recruited, and sociodemographic information, clinical characteristics, HCRU data, time spent on caregiving, and disease-related costs were collected from all eligible participants. A total of 599 eligible families were included in the study. Among them, 82.5% of families reported that their child had at least one outpatient or emergency room visit, while 5.8% of families reported that their child had been hospitalized in the past 12 months. The average annual cost across all cost categories amounted to 28 591.92 yuan per patient per year (PPPY), with 92.8% attributed to direct costs. Out-of-pocket expenses accounted for 90.7% of the cost of outpatient or emergency room visits and 43.4% of the cost of hospitalization. Factors associated with higher annual total costs included moderate (coefficient ± SE: 0.22 ± 0.09, P = 0.012) and severe AD patient groups (coefficient ± SE: 0.58 ± 0.15, P < 0.001), onset of AD on the head, neck, or hands (coefficient ± SE: 0.57 ± 0.14, P < 0.001), use of biological agents (coefficient ± SE: 0.64 ± 0.11, P < 0.001), and use of traditional Chinese medicine (TCM) (coefficient ± SE: 0.26 ± 0.09, P = 0.003), compared with their respective reference groups. This study highlighted a considerable economic burden of AD among pediatric patients in China across different disease severity groups, with significantly higher costs observed in patients with more severe disease. Additionally, factors such as disease severity, clinical characteristics, and treatment modalities might contribute to the higher costs encountered by pediatric patients with AD.

Key words: Atopic dermatitis, Economic burden, Healthcare resource utilization, Associated factors

Supporting:

Zhifeng Nie, Ruowei Xiao, Jiafang Song, Sheng Han, Wei Li, He Zhu, Luwen Shi. Economic burden and healthcare resource utilization of childhood atopic dermatitis in China[J]. Journal of Chinese Pharmaceutical Sciences, 2024, 33(5): 458-469.

Figures/Tables 5

Table 1. Socio-demographic and clinical profile of children with AD.

Table 2. HCRU for children with AD in the past year.

Table 3. Costs for families of children with AD in the past year.

Table 4. Factors associated with annual total costs using a GLM.

Table 5. Subgroup analyses for annual total costs.

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