Comorbidities, Healthcare Utilization, and Costs Associated With Alopecia Totalis and Alopecia Universalis in the United States

Main Article Content

Carolyn Maskin
Arash Mostaghimi
Aster Meche
Markqayne Ray
Kavita Gandhi
David Gruben
Vanja Sikirica

Keywords

Alopecia areata, Alopecia totalis, Alopecia universalis, cost, healthcare burden, US claims database, healthcare resource utilization

Abstract

Background: Alopecia areata (AA) is an autoimmune disease characterized by nonscarring hair loss. Extensive forms of AA include alopecia totalis (AT; complete scalp hair loss) or alopecia universalis (AU; complete scalp, face, and body hair loss). Limited information exists about the cost and healthcare burden of AT and AU.


Methods: Using a large US administrative healthcare claims database, two mutually exclusive patient cohorts were identified: AA cohort: ≥1 diagnosis of AA; AT/AU cohort: ≥1 diagnosis of AT/AU between January 1 and December 31, 2017. Baseline characteristics measured at first AA diagnosis (index date) and all-cause healthcare utilization and costs identified in the 1-year post-index period were compared between AT/AU and non-AT/AU AA cohorts.


Results: 14,340 patients with AA were identified, including 1,224 patients with AT or AU. Compared with patients with non-AT/AU AA (n=13,116), patients with AT/AU were older (mean age 43.1 vs 40.6 years, P<0.0001) and more were female (68.1% vs 62.9%, P<0.0001). More patients with AT/AU had baseline comorbidities (atopic disease [28.3% vs 24.1%], anemia [10.4% vs 7.4%], autoimmune disorders [9.6% vs 5.5%]; P≤0.001 for all). Post-index patients with AT/AU had higher per person per policy year healthcare resource utilization and costs (P≤0.001) and total adjusted annual mean costs (P<0.05). Over 50% more patients with AT/AU received immunosuppressive agents than patients with non-AT/AU AA.


Conclusion: Patients with AT/AU had higher rates of comorbidities and greater healthcare resource utilization medical costs than patients with non-AT/AU AA, suggesting that improved insight into the patterns of specific comorbid conditions is needed.

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