Resource Use and Costs in an Insured Population of Patients with Chronic Idiopathic/Spontaneous Urticaria

Abstract

BackgroundChronic idiopathic or spontaneous urticaria (CIU/CSU) impairs patients’ quality of life, and updated information on disease prevalence, treatment patterns, and disease burden is lacking.ObjectivesWe aimed to estimate these figures in a large US real-world claims database via a validated algorithm.MethodsIn this retrospective cross-sectional cohort study, we identified patients with CIU/CSU, estimated disease prevalence, comorbidities, and healthcare use (medications, office visits, emergency department visits, and hospitalizations) and costs (urticaria related and all cause).ResultsWe identified 6350 CIU/CSU patients in a population of just over 5.8 million: 0.11 % prevalence. Women accounted for the majority of sufferers (68.3 %) and had a greater burden of illness than men. Patients had relatively few comorbidities (mean 3.3, standard deviation 2.2). Primary care physicians and allergists were the most common providers of CIU/CSU-related care. Oral corticosteroids were the most commonly prescribed medication, used in 54.7 % of patients. Patients accumulated a mean of 15.1 office visits per year (standard deviation 12.6). The mean all-cause healthcare cost totaled over US$9000 per year.ConclusionsAlthough the disease affects a relatively young population, CIU/CSU carries a substantial cost. Frequent oral corticosteroid use in CIU/CSU patients is a concern because of adverse events associated with the drug.Electronic supplementary materialThe online version of this article (doi:10.1007/s40257-015-0134-8) contains supplementary material, which is available to authorized users.

H1‐antihistamine‐refractory chronic spontaneous urticaria: it's worse than we thought – first results of the multicenter real‐life AWARE study

“…This study indicates that approximately 25% of H1‐antihistamine‐refractory CSU patients have comorbid CIndU. Consistent with previous publications, other comorbidities in this patient population included asthma, allergic rhinitis, atopic dermatitis, allergies, and autoimmune diseases .…”

Patient-reported impact of chronic urticaria compared with psoriasis in theUnited States

“…For example, in the current analysis, 74% of patients with CU were women. This finding is consistent with retrospective database analyzes and other surveys where up to 70% of patients with CU and CIU were women (19,20). In addition, in the current analysis, 46% of patients with CU reported a history of nasal allergies, which was greater than the overall 28% of patients with psoriasis, and is comparable to the 43% of patients in the United States with CIU who reported a history of allergic rhinitis in a retrospective database analysis (19).…”

Prevalence of chronic urticaria in children and adults across the globe: Systematic review with meta‐analysis

“…41 Interestingly, one study from Asia found no sex-specific difference and it was the study including only children (4-13 years). 32 Evaluating sex-specific differences in children < 15 years in three studies, 28,32,33 we found again no sexspecific difference. A sex-related prevalence shift from childhood to adulthood has been identified for allergies, like allergic rhinitis in adolescence 42,43 and asthma after the onset of puberty.…”

“…Seven studies presented data stratified by sex. The point prevalence estimate for women was slightly higher than for men with overlapping corresponding 95% CIs based on random effect meta‐analysis: 1.3% (95% CI 0.1‐2.2) vs 0.8% (95% CI 0.2‐3.2) (Figure ).…”

“…Based on eleven studies, [20][21][22][25][26][27][28][29][32][33][34] the overall point prevalence of CU was 0.7% (95% CI 0.2-1.4, I 2 = 100%) ( Figure 3). Most studies presented 12-month prevalence estimates; however, three studies assessed the prevalence of current treatment for CU 22,26,29 and one study the combination of one-week prevalence plus current treatment.…”