Study Reveals the Economic Burden for Patients with Vitiligo in the US Is Significant

A novel study(opens in new tab/window) in the Journal of Investigative Dermatology(opens in new tab/window), published by Elsevier, shows that patients with vitiligo incur significantly higher healthcare costs than people without this skin condition. The findings reveal an unmet need for cost-effective treatments and highlight the importance of fully identifying the drivers of economic burden for patients with vitiligo.

Lead investigator Khaled Ezzedine, MD, PhD, Department of Dermatology, AP-HP, Henri Mondor University Hospital, and Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE) - EA 7379, Université Paris-Est Créteil (UPEC), explains, "Data regarding the economic burden of vitiligo are scarce and outdated. Our study quantifies the healthcare costs and healthcare resource utilization (HCRU) among patients with vitiligo. Determining medical costs will help identify the main expenditure predictors and spending patterns."

Vitiligo, a chronic autoimmune disorder that affects 0.5-2.0% of the United States population, is characterized by skin depigmentation caused by the loss of melanocytes. Patients with vitiligo incur direct costs associated with their condition through medical fees, pharmacy expenses, and out-of-pocket costs (e.g., sunscreens, protective clothing, cosmetic concealers, and camouflage products). They may also experience indirect costs owing to psychosocial effects, loss of work productivity, and lost opportunities (e.g., marriage, career choice, promotions, salary increases, or education).

Dr. Ezzedine continues, "Patients with vitiligo are often reported to have psychological problems, such as depression, anxiety, and shame, leading to low self-esteem and social isolation. Higher costs for patients with vitiligo than for persons without it may partly be explained by a higher risk of mental health conditions as well as other comorbidities among patients with vitiligo, including thyroid disease, diabetes, and alopecia areata that impact the cost of the disease."

For this retrospective cohort analysis, the Merative MarketScan Commercial Database, healthcare costs, and HCRU were evaluated for 49,512 patients with vitiligo compared to 99,024 people without vitiligo in the US between January 2007 and December 2021.

Outcomes included all-cause and vitiligo-related costs (2021 dollars) and all-cause HCRU, including mental health-related HCRU. Patients with vitiligo incurred significantly higher all-cause costs ($15,551 vs $7,735) and vitiligo-related costs ($3,490 vs $54) costs than controls. Mental health-related HCRU was also significantly higher among patients with vitiligo. Taken together, healthcare costs and HCRU were significantly higher among patients with vitiligo than among controls.

In this analysis, the increased costs were associated with significantly higher inpatient costs, ER visits, ambulatory visits, number of prescriptions and prescriptions costs, and other costs (e.g., medical equipment and home healthcare), illustrating the importance of independently evaluating the economic burden of different skin conditions. The results from this study show that the economic burden of vitiligo was comparable with those of other well-studied dermatologic conditions, such as atopic dermatitis and psoriasis.

This study shows that the increased healthcare costs for patients with vitiligo versus those of non-vitiligo controls were driven by medical costs rather than pharmacy costs, and the increased HCRU was primarily the result of outpatient visits compared with inpatient or ER visits, which aligns with the main cost drivers identified in studies of the economic burden of atopic dermatitis and psoriasis.

Dr. Ezzedine concludes, "The healthcare costs and HCRU for patients in the US with vitiligo in this study were significantly higher than for patients without a vitiligo diagnosis. The economic burden was markedly higher for patients receiving treatment with systemic effects or with new mental health diagnoses than for the total vitiligo population. These findings reveal an unmet need for cost-effective treatments and highlight the importance of fully identifying the drivers of economic burden for patients with vitiligo."

Notes for editors

The article is “Economic Burden Among Patients with Vitiligo in the United States: A Retrospective Database Claims Study,” by Khaled Ezzedine, Ahmed M. Soliman, Chao Li, Heidi S. Camp, and Amit G. Pandya (https://doi.org/10.1016/j.jid.2023.08.025(opens in new tab/window)). It appears online in the Journal of Investigative Dermatology ahead of volume 144, issue 3(March 2024), published by Elsevier.

The article is openly available at https://www.jidonline.org/article/S0022-202X(23)02593-9/fulltext(opens in new tab/window).

The full text of the article is also available to credentialed journalists upon request; contact Theresa Monturano at +1 215 239 3711 or[email protected](opens in new tab/window). Journalists wishing to interview the authors should contact Khaled Ezzedine, MD, PhD, at [email protected](opens in new tab/window).

About the Journal of Investigative Dermatology

The Journal of Investigative Dermatology(opens in new tab/window) (JID) is the official journal of the Society of Investigative Dermatology and the European Society for Dermatological Research. JID publishes high impact reports describing original research related to all aspects of cutaneous biology and skin diseases. Descriptions of important findings that result from basic, translational, or clinical research are published. Clinical research can include, but is not limited to, interventional trials, genetics studies, epidemiology, and health services research. www.jidonline.org(opens in new tab/window)

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