Economic Burden of Itch-Related Sleep Loss in Moderate-to-Severe Atopic Dermatitis in the United Kingdom

Evangeline J Pierce; Russel T Burge; Alex J Hirst; Aimée M Fox; Anu K Suokas; Yunni Yi

doi:10.1007/s13555-024-01153-9

Economic Burden of Itch-Related Sleep Loss in Moderate-to-Severe Atopic Dermatitis in the United Kingdom

Dermatol Ther (Heidelb). 2024 Apr 23. doi: 10.1007/s13555-024-01153-9. Online ahead of print.

Authors

Evangeline J Pierce¹, Russel T Burge², Alex J Hirst³, Aimée M Fox³, Anu K Suokas³, Yunni Yi³

Affiliations

¹ Lilly Corporate Center, Eli Lilly and Company, 893 Delaware St, Indianapolis, IN, 46285, USA. evangeline.pierce@lilly.com.
² Lilly Corporate Center, Eli Lilly and Company, 893 Delaware St, Indianapolis, IN, 46285, USA.
³ Adelphi Values PROVE, Cheshire, England, UK.

PMID: 38652379
DOI: 10.1007/s13555-024-01153-9

Abstract

Introduction: Atopic dermatitis is associated with intense itch, which has been shown to cause sleep disruption that significantly impacts the lives of patients with atopic dermatitis. Despite this, little is known about its burden to the healthcare system and society. This study aimed to quantify the economic burden of itch-related sleep loss in moderate-to-severe atopic dermatitis in the UK.

Methods: A literature-based decision-analytic model was developed from a healthcare payer and societal perspective. The model quantifies the economic burden by linking the severity of itch to the number of days of sleep disruption. The model captures the direct costs of healthcare resource utilization and treatment alongside the indirect costs of productivity loss from absenteeism and presenteeism at work over a 5-year time horizon. The patient population considered was patients aged ≥ 15 years with moderate-to-severe atopic dermatitis and itch-related sleep disruption.

Results: The model estimated that itch-related sleep disruption as a result of moderate-to-severe atopic dermatitis would affect an average of 821,142 people over the time horizon (2022 to 2026). This translates into an average net economic burden of £3.8 billion (£4687 per patient), with an average of 172 million days being affected by sleep disruption per year in the UK. The greatest contributor to the annual average net economic burden was productivity loss from absenteeism and presenteeism, each accounting for 34%. The direct costs (treatment costs and healthcare resource use) accounted for 32% of the net economic burden. The results showed a high and gradually increasing economic burden over the 5-year time horizon.

Conclusions: Sleep disruption has a high economic burden and reducing itch may provide substantial direct and indirect savings. Quantifying the economic burden of itch-related sleep loss may provide support for analyses to inform public health policies for treatment of atopic dermatitis, particularly within the moderate-to-severe level.

Keywords: Atopic dermatitis; Burden of disease; Cost-of-illness model; Itch-related sleep disruption; Work impairment.