Health Utility Scores of Atopic Dermatitis in US Adults

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

doi:10.1016/j.jaip.2018.11.043

Health Utility Scores of Atopic Dermatitis in US Adults

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

^*Corresponding author for this work

Dermatology

Research output: Contribution to journal › Article › peer-review

55 Scopus citations

Abstract

Background: The impact of atopic dermatitis (AD) on health-related quality of life and health utility in the US adult population is not well established. Objective: To determine the health utilities and quality-adjusted life-years (QALYs) lost in adults with AD versus without AD in the US population. Methods: A cross-sectional, population-based study of 3495 adults was performed. AD was determined using modified UK diagnostic criteria for AD. AD severity was assessed using self-reported global AD severity, the Patient-Oriented Eczema Measure, the Patient-Oriented Scoring AD, and the Patient-Oriented Scoring AD itch and sleep. Six-dimensional health state short form (SF-6D) health utility scores and total QALY loss were assessed. Results: The mean SF-6D score was lower in adults with AD compared with healthy adults (0.69 [95% CI, 0.68-0.70] versus 0.79 [95% CI, 0.77-0.79]). In particular, those with moderate-to-severe AD (mean, 0.53-0.66) had similar or lower SF-6D scores compared with those with all other self-reported disorders examined, except autoimmune disorders. Adults with AD and atopic comorbidities had significantly lower SF-6D scores compared with 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. Conclusions: 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.

Original language	English (US)
Pages (from-to)	1246-1252.e1
Journal	Journal of Allergy and Clinical Immunology: In Practice
Volume	7
Issue number	4
DOIs	https://doi.org/10.1016/j.jaip.2018.11.043
State	Published - Apr 2019

Funding

The Atopic Dermatitis in America Study is an independent research project of the Asthma and Allergy Foundation of America in partnership with the National Eczema Association and sponsored by Sanofi Genzyme and Regeneron.Conflicts of interest: J. I. Silverberg served as a consultant and/or advisory board member for Abbvie, Asana, Eli Lilly, Galderma, GlaxoSmithKline, Glenmark, Kiniksa, Leo, Menlo, Pfizer Inc, Regeneron-Sanofi, Realm, and Roivant receiving honoraria; served as a speaker for Regeneron-Sanofi; received research grants from GlaxoSmithKline and Regeneron-Sanofi; and is supported by the Dermatology Foundation. J. M. Gelfand served as a consultant for BMS, Boehringer Ingelheim, GlaxoSmithKline, Janssen Biologics, Menlo Therapeutics, Novartis Corp, Regeneron, Dr Reddy's Labs, UCB (DSMB), Sanofi, and Pfizer Inc, receiving honoraria; receives research grants (to the Trustees of the University of Pennsylvania) from Abbvie, Janssen, Novartis Corp, Sanofi, Celgene, Ortho Dermatologics, and Pfizer Inc; received payment for continuing medical education work related to psoriasis that was supported indirectly by Lilly and Ortho Dermatologics; is a co-patent holder of resiquimod for treatment of cutaneous T-cell lymphoma; and is a Deputy Editor for the Journal of Investigative Dermatology receiving honoraria from the Society for Investigative Dermatology. D. J. Margolis is the chair of the data monitoring committee for many Sanofi clinical trials of dupilamab; and, with respect to atopic dermatitis, has received independent research funding for his institution from the National Institute of Health and Valeant. M. Boguniewicz has received research funding from Anacor and Regeneron and consulted for Regeneron, Sanofi Genzyme, and Pfizer Inc. L. Fonacier has served as a consultant for Regeneron, receiving honoraria; served as a speaker for Regeneron; and received research and educational grants from Genentech, Baxter, and Pfizer Inc. M. H. Grayson is a board member of Allergy and Asthma Foundation of America (AAFA) and chair for the AAFA Medical Scientific Council; and has served as a consultant for AstraZeneca. P. Y. Ong is a co-investigator of Atopic Dermatitis Research Network; has consulted for Pfizer Inc and Theravance; and has received research funding from Regeneron. Z. Chiesa Fuxench has served as a consultant for the National Eczema Association and the Asthma and Allergy Foundation, receiving honoraria; receives or has received research grants (to the Trustees of the University of Pennsylvania) from Regeneron, Sanofi, Tioga Pharmaceuticals, Vanda Pharmaceuticals, and Realm Therapeutics for work in atopic dermatitis; and has received payment for continuing medical education work related to atopic dermatitis that was supported indirectly by Regeneron and/or Sanofi. E. L. Simpson has served as a consultant and/or advisory board member for Regeneron-Sanofi. The Atopic Dermatitis in America Study is an independent research project of the Asthma and Allergy Foundation of America in partnership with the National Eczema Association and sponsored by Sanofi Genzyme and Regeneron. Conflicts of interest: J. I. Silverberg served as a consultant and/or advisory board member for Abbvie, Asana, Eli Lilly, Galderma, GlaxoSmithKline, Glenmark, Kiniksa, Leo, Menlo, Pfizer Inc, Regeneron-Sanofi, Realm, and Roivant receiving honoraria; served as a speaker for Regeneron-Sanofi; received research grants from GlaxoSmithKline and Regeneron-Sanofi; and is supported by the Dermatology Foundation. J. M. Gelfand served as a consultant for BMS, Boehringer Ingelheim, GlaxoSmithKline, Janssen Biologics, Menlo Therapeutics, Novartis Corp, Regeneron, Dr Reddy's Labs, UCB (DSMB), Sanofi, and Pfizer Inc, receiving honoraria; receives research grants (to the Trustees of the University of Pennsylvania) from Abbvie, Janssen, Novartis Corp, Sanofi, Celgene, Ortho Dermatologics, and Pfizer Inc; received payment for continuing medical education work related to psoriasis that was supported indirectly by Lilly and Ortho Dermatologics; is a co-patent holder of resiquimod for treatment of cutaneous T-cell lymphoma; and is a Deputy Editor for the Journal of Investigative Dermatology receiving honoraria from the Society for Investigative Dermatology. D. J. Margolis is the chair of the data monitoring committee for many Sanofi clinical trials of dupilamab; and, with respect to atopic dermatitis, has received independent research funding for his institution from the National Institute of Health and Valeant. M. Boguniewicz has received research funding from Anacor and Regeneron and consulted for Regeneron, Sanofi Genzyme, and Pfizer Inc. L. Fonacier has served as a consultant for Regeneron, receiving honoraria; served as a speaker for Regeneron; and received research and educational grants from Genentech, Baxter, and Pfizer Inc. M. H. Grayson is a board member of Allergy and Asthma Foundation of America (AAFA) and chair for the AAFA Medical Scientific Council; and has served as a consultant for AstraZeneca. P. Y. Ong is a co-investigator of Atopic Dermatitis Research Network; has consulted for Pfizer Inc and Theravance; and has received research funding from Regeneron. Z. Chiesa Fuxench has served as a consultant for the National Eczema Association and the Asthma and Allergy Foundation, receiving honoraria; receives or has received research grants (to the Trustees of the University of Pennsylvania) from Regeneron, Sanofi, Tioga Pharmaceuticals, Vanda Pharmaceuticals, and Realm Therapeutics for work in atopic dermatitis; and has received payment for continuing medical education work related to atopic dermatitis that was supported indirectly by Regeneron and/or Sanofi. E. L. Simpson has served as a consultant and/or advisory board member for Regeneron-Sanofi. The Atopic Dermatitis in America Study is an independent research project of the Asthma and Allergy Foundation of America in partnership with the National Eczema Association and sponsored by Sanofi Genzyme and Regeneron . The Atopic Dermatitis in America Study is an independent research project of the Asthma and Allergy Foundation of America in partnership with the National Eczema Association and sponsored by Sanofi Genzyme and Regeneron.Conflicts of interest: J. I. Silverberg served as a consultant and/or advisory board member for Abbvie, Asana, Eli Lilly, Galderma, GlaxoSmithKline, Glenmark, Kiniksa, Leo, Menlo, Pfizer Inc, Regeneron-Sanofi, Realm, and Roivant receiving honoraria; served as a speaker for Regeneron-Sanofi; received research grants from GlaxoSmithKline and Regeneron-Sanofi; and is supported by the Dermatology Foundation. J. M. Gelfand served as a consultant for BMS, Boehringer Ingelheim, GlaxoSmithKline, Janssen Biologics, Menlo Therapeutics, Novartis Corp, Regeneron, Dr Reddy's Labs, UCB (DSMB), Sanofi, and Pfizer Inc, receiving honoraria; receives research grants (to the Trustees of the University of Pennsylvania) from Abbvie, Janssen, Novartis Corp, Sanofi, Celgene, Ortho Dermatologics, and Pfizer Inc; received payment for continuing medical education work related to psoriasis that was supported indirectly by Lilly and Ortho Dermatologics; is a co-patent holder of resiquimod for treatment of cutaneous T-cell lymphoma; and is a Deputy Editor for the Journal of Investigative Dermatology receiving honoraria from the Society for Investigative Dermatology. D. J. Margolis is the chair of the data monitoring committee for many Sanofi clinical trials of dupilamab; and, with respect to atopic dermatitis, has received independent research funding for his institution from the National Institute of Health and Valeant. M. Boguniewicz has received research funding from Anacor and Regeneron and consulted for Regeneron, Sanofi Genzyme, and Pfizer Inc. L. Fonacier has served as a consultant for Regeneron, receiving honoraria; served as a speaker for Regeneron; and received research and educational grants from Genentech, Baxter, and Pfizer Inc. M. H. Grayson is a board member of Allergy and Asthma Foundation of America (AAFA) and chair for the AAFA Medical Scientific Council; and has served as a consultant for AstraZeneca. P. Y. Ong is a co-investigator of Atopic Dermatitis Research Network; has consulted for Pfizer Inc and Theravance; and has received research funding from Regeneron. Z. Chiesa Fuxench has served as a consultant for the National Eczema Association and the Asthma and Allergy Foundation, receiving honoraria; receives or has received research grants (to the Trustees of the University of Pennsylvania) from Regeneron, Sanofi, Tioga Pharmaceuticals, Vanda Pharmaceuticals, and Realm Therapeutics for work in atopic dermatitis; and has received payment for continuing medical education work related to atopic dermatitis that was supported indirectly by Regeneron and/or Sanofi. E. L. Simpson has served as a consultant and/or advisory board member for Regeneron-Sanofi.

Keywords

Atopic dermatitis
Eczema
Epidemiology
Health-related quality of life
Patient burden
Quality-adjusted life-years
Utility

ASJC Scopus subject areas

Immunology and Allergy

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jaip.2018.11.043

Cite this

@article{c26f5d60be1d4e18b55e396b982d98fe,

title = "Health Utility Scores of Atopic Dermatitis in US Adults",

abstract = "Background: The impact of atopic dermatitis (AD) on health-related quality of life and health utility in the US adult population is not well established. Objective: To determine the health utilities and quality-adjusted life-years (QALYs) lost in adults with AD versus without AD in the US population. Methods: A cross-sectional, population-based study of 3495 adults was performed. AD was determined using modified UK diagnostic criteria for AD. AD severity was assessed using self-reported global AD severity, the Patient-Oriented Eczema Measure, the Patient-Oriented Scoring AD, and the Patient-Oriented Scoring AD itch and sleep. Six-dimensional health state short form (SF-6D) health utility scores and total QALY loss were assessed. Results: The mean SF-6D score was lower in adults with AD compared with healthy adults (0.69 [95% CI, 0.68-0.70] versus 0.79 [95% CI, 0.77-0.79]). In particular, those with moderate-to-severe AD (mean, 0.53-0.66) had similar or lower SF-6D scores compared with those with all other self-reported disorders examined, except autoimmune disorders. Adults with AD and atopic comorbidities had significantly lower SF-6D scores compared with 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. Conclusions: 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.",

keywords = "Atopic dermatitis, Eczema, Epidemiology, Health-related quality of life, Patient burden, Quality-adjusted life-years, Utility",

author = "Silverberg, {Jonathan I.} and Gelfand, {Joel M.} and Margolis, {David J.} and Mark Boguniewicz and Luz Fonacier and Grayson, {Mitchell H.} and Ong, {Peck Y.} and Fuxench, {Zelma Chiesa} and Simpson, {Eric L.}",

note = "Publisher Copyright: {\textcopyright} 2018 The Authors",

year = "2019",

month = apr,

doi = "10.1016/j.jaip.2018.11.043",

language = "English (US)",

volume = "7",

pages = "1246--1252.e1",

journal = "Journal of Allergy and Clinical Immunology: In Practice",

issn = "2213-2198",

publisher = "American Academy of Allergy, Asthma and Immunology",

number = "4",

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T1 - Health Utility Scores of Atopic Dermatitis in US Adults

AU - Silverberg, Jonathan I.

AU - Gelfand, Joel M.

AU - Margolis, David J.

AU - Boguniewicz, Mark

AU - Fonacier, Luz

AU - Grayson, Mitchell H.

AU - Ong, Peck Y.

AU - Fuxench, Zelma Chiesa

AU - Simpson, Eric L.

PY - 2019/4

Y1 - 2019/4

N2 - Background: The impact of atopic dermatitis (AD) on health-related quality of life and health utility in the US adult population is not well established. Objective: To determine the health utilities and quality-adjusted life-years (QALYs) lost in adults with AD versus without AD in the US population. Methods: A cross-sectional, population-based study of 3495 adults was performed. AD was determined using modified UK diagnostic criteria for AD. AD severity was assessed using self-reported global AD severity, the Patient-Oriented Eczema Measure, the Patient-Oriented Scoring AD, and the Patient-Oriented Scoring AD itch and sleep. Six-dimensional health state short form (SF-6D) health utility scores and total QALY loss were assessed. Results: The mean SF-6D score was lower in adults with AD compared with healthy adults (0.69 [95% CI, 0.68-0.70] versus 0.79 [95% CI, 0.77-0.79]). In particular, those with moderate-to-severe AD (mean, 0.53-0.66) had similar or lower SF-6D scores compared with those with all other self-reported disorders examined, except autoimmune disorders. Adults with AD and atopic comorbidities had significantly lower SF-6D scores compared with 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. Conclusions: 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.

AB - Background: The impact of atopic dermatitis (AD) on health-related quality of life and health utility in the US adult population is not well established. Objective: To determine the health utilities and quality-adjusted life-years (QALYs) lost in adults with AD versus without AD in the US population. Methods: A cross-sectional, population-based study of 3495 adults was performed. AD was determined using modified UK diagnostic criteria for AD. AD severity was assessed using self-reported global AD severity, the Patient-Oriented Eczema Measure, the Patient-Oriented Scoring AD, and the Patient-Oriented Scoring AD itch and sleep. Six-dimensional health state short form (SF-6D) health utility scores and total QALY loss were assessed. Results: The mean SF-6D score was lower in adults with AD compared with healthy adults (0.69 [95% CI, 0.68-0.70] versus 0.79 [95% CI, 0.77-0.79]). In particular, those with moderate-to-severe AD (mean, 0.53-0.66) had similar or lower SF-6D scores compared with those with all other self-reported disorders examined, except autoimmune disorders. Adults with AD and atopic comorbidities had significantly lower SF-6D scores compared with 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. Conclusions: 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.

KW - Atopic dermatitis

KW - Eczema

KW - Epidemiology

KW - Health-related quality of life

KW - Patient burden

KW - Quality-adjusted life-years

KW - Utility

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Health Utility Scores of Atopic Dermatitis in US Adults

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UN SDGs

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