Introduction

Alopecia areata (AA) is an autoimmune disorder causing sudden, non-scarring hair loss. There are currently no drugs approved for AA treatment. This study assessed prevalence of comorbidities, treatments, and healthcare costs and resource utilization among patients with AA in the USA.

Methods

Patients diagnosed with AA between January 2011 and December 2018 were identified in IBM MarketScan^® Research Databases. Eligible patients had no other hair loss-related disorders and were continuously enrolled with medical and pharmacy benefits at least 12 months before and after AA diagnosis. Descriptive statistics were used to summarize comorbid conditions, treatments related to AA or other autoimmune/inflammatory conditions, and all-cause and AA-specific healthcare costs and resource utilization identified from claims data.

Results

A total of 68,121 patients with AA were identified. Mean (SD) age was 40.3 (17.8) years and 61.0% were female. The most common comorbidities included hyperlipidemia (22.4%), hypertension (21.8%), thyroid disorders (13.1%), contact dermatitis or eczema (10.8%), depression (9.5%), and anxiety (8.4%). Comorbid autoimmune diseases included atopic dermatitis (2.8%), psoriasis (2.1%), chronic urticaria (1.5%), and rheumatoid arthritis (1.1%). During the 12-month follow-up period, 37,995 patients (55.8%) were prescribed treatment for their AA or other comorbid autoimmune/inflammatory disease; 44.9% of treated patients were prescribed therapy within 7 days of AA diagnosis. Of patients receiving treatment, 80.3% received topical steroids and 30.0% received oral steroids. Mean (SD) total healthcare costs were $11,241.21 ($43,839.69) for all-causes and $419.12 ($1534.99) for AA. AA-related expenses were driven by outpatient and prescription costs.

Conclusion

Patients with AA have a high comorbidity burden and lack of treatment. Current AA treatments, including systemic therapies other than oral steroids, were not frequently utilized in this study population. Healthcare costs incurred by patients with AA went beyond AA-related expenses. Longitudinal data are needed to better understand treatment trajectories and the disease burden in patients with AA.

中文翻译：

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使用保险索赔的美国人群斑秃治疗模式、医疗资源利用和合并症

介绍

斑秃 (AA) 是一种自身免疫性疾病，会导致突然的、无疤痕的脱发。目前没有批准用于 AA 治疗的药物。本研究评估了美国 AA 患者的合并症患病率、治疗、医疗保健费用和资源利用情况。

方法

^在IBM MarketScan®研究数据库中确定了 2011 年 1 月至 2018 年 12 月期间诊断为 AA 的患者。符合条件的患者没有其他与脱发相关的疾病，并且在 AA 诊断前后至少 12 个月连续参加医疗和药学福利。描述性统计用于总结合并症、与 AA 或其他自身免疫/炎症状况相关的治疗，以及从索赔数据中确定的全因和 AA 特定的医疗保健成本和资源利用。

结果

共确定了 68,121 名 AA 患者。平均 (SD) 年龄为 40.3 (17.8) 岁，61.0% 为女性。最常见的合并症包括高脂血症（22.4%）、高血压（21.8%）、甲状腺疾病（13.1%）、接触性皮炎或湿疹（10.8%）、抑郁症（9.5%）和焦虑症（8.4%）。合并的自身免疫性疾病包括特应性皮炎 (2.8%)、银屑病 (2.1%)、慢性荨麻疹 (1.5%) 和类风湿性关节炎 (1.1%)。在 12 个月的随访期间，37,995 名患者 (55.8%) 接受了治疗 AA 或其他并存的自身免疫性/炎症性疾病的治疗；44.9% 的接受治疗的患者在 AA 诊断后 7 天内接受了治疗。在接受治疗的患者中，80.3% 接受了局部类固醇，30.0% 接受了口服类固醇。所有原因的平均 (SD) 总医疗保健费用为 11,241.21 美元（43,839.69 美元）和 419 美元。12 美元（1534.99 美元）用于 AA。AA 相关费用由门诊和处方费用驱动。

结论

AA 患者的合并症负担高且缺乏治疗。目前的 AA 治疗，包括除口服类固醇以外的全身治疗，在该研究人群中并未经常使用。AA 患者发生的医疗保健费用超出了与 AA 相关的费用。需要纵向数据来更好地了解 AA 患者的治疗轨迹和疾病负担。