Health-related quality of life and economic burden of prurigo nodularis - 27/06/21

Doi : 10.1016/j.jaad.2021.05.036

Katherine A. Whang, MD ^a, Thomas K. Le, BS ^a, Raveena Khanna, MD ^a, Kyle A. Williams, BS ^a, Youkyung Sophie Roh, BA ^a, Nishadh Sutaria, BS ^a, Justin Choi, BS ^a, Sylvie Gabriel, MD, MBA ^b, Rajeev Chavda, MD ^b, Yevgeniy Semenov, MD, MA ^c,^d, Shawn G. Kwatra, MD ^a,^e,^⁎
^a Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
^b Galderma Prescription Global Business Unit, Rue d'Entre-deux-Villes, La Tour-de-Peilz, Switzerland
^c Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts
^d Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts
^e Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland

^∗Correspondence to: Shawn G. Kwatra, MD, Cancer Research Building II, Johns Hopkins University School of Medicine, Suite 206, 1550 Orleans Street, Baltimore, MD 21231.Cancer Research Building IIJohns Hopkins University School of MedicineSuite 206, 1550 Orleans StreetBaltimoreMD21231

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Abstract

Background

Prurigo nodularis (PN) is an understudied, pruritic inflammatory skin disease. Little is known about the effect of PN on quality of life and its associated economic burden.

Objective

To quantify the impact of PN on quality of life and its economic implications.

Methods

A cohort study of PN patients (n = 36) was conducted using the Health Utilities Index Mark 3 questionnaire. Control data from US adults (n = 4187) were obtained from the 2002-2003 Joint Canada/United States Survey of Health. Quality-adjusted life year loss and economic costs were estimated by comparing the Health Utilities Index Mark 3 scores of the PN patients with those of the controls.

Results

The PN patients had lower overall health performance compared to the controls, (mean ± SE, 0.52 ± 0.06 vs 0.86 ± 0.003, respectively, P < .001). In multivariable regression, PN was found to be associated with worse health performance (coefficient −0.34, 95% CI [−0.46 to −0.23]), most prominent in the pain subdomain (coefficient −0.24, 95% CI [−0.35 to −0.13]). This correlated to an average of 6.5 lifetime quality-adjusted life years lost per patient, translating to an individual lifetime economic burden of $323,292 and a societal burden of $38.8 billion.

Conclusion

These results demonstrate that PN is associated with significant quality-of-life impairment, similar to the level of other chronic systemic conditions. PN is also associated with a substantial individual economic burden, emphasizing the necessity of research on effective treatment options.

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Key words : chronic pruritus, disease burden, economic burden, epidemiology, health utility, itch, prurigo nodularis, pruritus, quality of life

Abbreviations used : HUI3, PN, QALY, QoL

Plan

Introduction

Methods

Study design and study population

Statistical analysis

Assessing economic burden

Results

Discussion

	Drs Semenov and Kwarta are cofirst authors.
	Funding sources: Dr Kwatra received a research grant from Galderma and the Skin of Color Society and received a Medical Dermatology Career Development Award from the Dermatology Foundation.
	IRB approval status: This study was approved by the Johns Hopkins Institutional Review Board (IRB00157834).
	Reprints not available from the authors.