Study reveals the economic burden for patients with vitiligo in the US is significant

A novel study in the Journal of Investigative Dermatology, shows that patients with vitiligo incur significantly higher health care 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, Ph.D., 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7379, Université Paris-Est Créteil (UPEC), explains, "Data regarding the economic burden of vitiligo are scarce and outdated.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 health care costs and health care 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, health care 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, health care 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 health care), 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 health care 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 health care 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."