Impact of Targeted Therapy on Healthcare Resource Utilization Among Patients with Atopic Dermatitis

Abstract

Background: Atopic dermatitis (AD), the most prevalent inflammatory dermatologic condition, manifests as dry skin, erythema, and rashes. Although there have been many approvals of targeted therapies, no studies have quantified their impact on healthcare resource utilization (HCRU) and related costs among patients diagnosed with AD.Objective: To assess the impact of targeted therapy on intensive HCRU (inpatient and emergency department [ED] visits) and costs between those who have and have not been prescribed a targeted therapy among patients with AD in the US. Methods: Retrospective cohort study using MarketScan Commercial claims database. Subjects with AD who were prescribed and not prescribed a targeted therapy between January 1st, 2017 and December 31st, 2022 were identified. A difference-in-differences analysis was used to assess the effect of targeted therapy on HCRU and costs among AD patients. The study period was from January 1st, 2012, through December 31st, 2023. Results: We identified 157,966 individuals with AD, 148,646 of whom were not treated with a targeted therapy, while 9,320 received such treatment. Those who were prescribed a targeted therapy led to a 0.016 (95% CI: -0.021, -0.010; p-value < 0.01) decrease in the average proportion of inpatient visits and 0.017 (95% CI: -0.025, -0.008; p-value < 0.01) decrease in the average proportion of ED visits compared to those not on a targeted therapy. On average, targeted therapy was associated with an increase of $25,219 (95% CI: 24,759, 25,679; p-value < 0.01) in total cost and $26,061 (95% CI: 25,734, 26,387; p-value < 0.01) in drug cost, along with a $909 (95% CI: -1,106, -711; p-value < 0.01) decrease in outpatient cost and a $251 (95% CI: -382, -119; p-value < 0.01) decrease in inpatient cost compared to those not on a targeted therapy. Conclusion: We found a significant decrease in the average proportion of AD patients requiring inpatient or ED visits when treated with targeted therapy compared to those not on such therapy, suggesting that the targeted therapies may be effective in reducing intensive healthcare resource use. Further research should be conducted to understand how adherence to targeted therapy and treatment history can impact HCRU and cost.