Health utility scores of atopic dermatitis in US adults

Publication date: Available online 8 December 2018

Source: The Journal of Allergy and Clinical Immunology: In Practice

Author(s): Jonathan I. Silverberg, Joel M. Gelfand, David J. Margolis, Mark Boguniewicz, Luz Fonacier, Mitchell H. Grayson, Peck Y. Ong, Zelma Chiesa Fuxench, Eric L. Simpson

Background

The impact of atopic dermatitis (AD) on health related quality of life and health utility in the United States adult population is not well-established.

Objectives

To determine the health utilities and quality of life adjusted years (QALYs) lost in adults with vs. without AD among the US population.

Methods

A cross-sectional, population-based study of 3,495 adults was performed. AD was determined using modified UK Diagnostic Criteria for AD. AD severity was assessed using self-reported global AD severity, Patient-Oriented Eczema Measure (POEM), Patient-Oriented Scoring AD (PO-SCORAD), PO-SCORAD-itch and sleep. SF-6D health utility scores and total QALY loss were assessed.

Results

The mean [95% confidence interval] SF-6D score was lower in adults with AD compared to healthy adults (0.69 [0.68-0.70] vs. 0.79 [0.77-0.79]). In particular, moderate-severe AD (mean: 0.53-0.66) had similar or lower SF-6D scores than all other self-reported disorders examined, except autoimmune disorders. Adults with AD and atopic comorbidities had significantly lower SF-6D scores compared to those without atopic comorbidities. Among the 7 disorders examined, AD was associated with higher total QALY loss than autoimmune disorders, diabetes, food allergy, and heart disease in both males and females. The largest QALY loss was for moderate AD in females and mild AD in males.

Conclusion

Moderate-to-severe AD is associated with significant decrements of health utility in the US population. These data illustrate the heavy societal burden of moderate and severe AD and provide important insight for prioritization of resource allocation and cost-effectiveness research.

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