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Treatment Patterns and Healthcare Utilization on Pediatric Atopic Dermatitis With Allergic Comorbidities: A Japanese
Masaki Futamura1, Yumi Kang2, Ambrish Singh3
1Department of Pediatrics, NHO Nagoya Medical Center, Aichi, Japan.
Insights
Children with atopic dermatitis (AD) and allergic comorbidities (ACMs) face a higher clinical and economic burden. Real-world data show increased healthcare utilization and costs for pediatric AD patients with co-existing allergic conditions.
Area of Science:
- Pediatric Dermatology
- Allergy and Immunology
- Health Economics
Background:
- Atopic dermatitis (AD) is a chronic, pruritic skin condition often starting in infancy.
- High co-occurrence of allergic comorbidities (ACMs) like asthma, food allergy, and allergic rhinitis presents a significant public health challenge.
- Limited real-world data exist on treatment patterns and economic burden of pediatric AD, particularly concerning ACMs.
Purpose of the Study:
- To assess the clinical profiles and healthcare utilization of pediatric patients with AD.
- To evaluate the economic burden associated with AD in children, considering the presence of allergic comorbidities.
- To analyze treatment patterns for AD in children with and without ACMs.
Main Methods:
- Retrospective observational study utilizing the JMDC Claims database.
- Inclusion of children aged 0-6 years diagnosed with AD between January 2018 and September 2023.
- Analysis of 244,316 pediatric AD cases, comparing those with AD-only versus those with AD and ACMs.
Main Results:
- 82.3% of pediatric AD patients had co-existing ACMs, with allergic rhinitis being most prevalent.
- Patients with AD and ACMs exhibited higher healthcare utilization, including more outpatient visits and shorter hospital stays.
- Median annual healthcare costs were substantially higher for children with AD and ACMs (139,391 Yen) compared to AD-only (98,646 Yen), increasing with the number of ACMs.
Conclusions:
- The presence of allergic comorbidities significantly increases the clinical and economic burden in pediatric patients with atopic dermatitis.
- Treatment patterns, including the use of topical and systemic corticosteroids and antihistamines, differ between AD-only and AD with ACMs groups.
- Findings underscore the need for intensive management strategies and dedicated healthcare resources to address the multifaceted burden of pediatric AD with ACMs.
Abstract:
Atopic dermatitis (AD) is a chronic, itchy skin disease that often begins in infancy and may persist into adulthood. The high co-occurrence of allergic comorbidities (ACMs; asthma, food allergy, and allergic rhinitis) makes it a growing public health concern. However, real-world data on treatment patterns and the economic burden of AD in children remain sparse. This retrospective observational study aimed to assess the clinical profiles of pediatric patients with AD using data from the JMDC Claims database. Children aged 0-6 years diagnosed with AD between January 2018 and September 2023 were included. A total of 244 316 children with AD (mean age: 3.1 years; 51.3% male) were included. Of these, 17.7% had AD-only, and 82.3% had AD with ACM. Allergic rhinitis was the most prevalent ACM. Topical corticosteroids were the most prescribed treatment, with 94.0% of patients with ACMs and 85.5% of those with AD-only receiving them. Potent corticosteroids were more frequently used in the AD with ACM group. Systemic steroids (31.5% vs. 4.8%) and antihistamines (95.5% vs. 56.1%) were used more often in the AD with ACMs group than in the AD-only group. Patients in the AD with ACM versus AD-only group had more outpatient visits (11.1/year vs. 6.5/year) and comparable hospitalization frequency, but shorter hospital stays (2.4 vs. 7.7 days per year). Median annual healthcare costs were substantially higher in the AD with ACM group compared to the AD-only group (139 391 Yen vs. 98 646 Yen), with costs increasing as the number of ACMs increased. Notably, 84.7% of patients with three ACMs incurred annual healthcare costs exceeding 100 000 Yen. These findings highlighted the increased clinical and economic burden associated with the increasing number of ACMs in children with AD, emphasizing the need for more intensive treatment and healthcare resources.
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