Patients with vitiligo incur significantly higher healthcare costs than people without this skin condition, finds a new study in the Journal of Investigative Dermatology.
“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.”
–Khaled Ezzedine, MD, PhD, of the Department of Dermatology at AP-HP at Henri Mondor University Hospital in Créteil, France, in a news release.
For this retrospective cohort analysis, the Merative MarketScan Commercial Database, healthcare costs, and health care resource utilization (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.
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). Patients with vitiligo may also have psychological problems, such as depression, anxiety, and shame, leading to low self-esteem and social isolation.
Study 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, the study showed.
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). 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, the study authors note.
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.
“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,” says lead investigator Khaled Ezzedine, MD, PhD, of the Department of Dermatology at AP-HP at Henri Mondor University Hospital in Créteil, France, in a news release.
“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,” Dr. Ezzedine says. “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.”
