Department of Dermatology, Nagasaki University, Nagasaki, Japan.
CRECON Medical Assessment Inc., Tokyo, Japan.
J Dermatol. 2020 Jul;47(7):689-698. doi: 10.1111/1346-8138.15366. Epub 2020 May 7.
Atopic dermatitis is a pruritic, eczematous dermatitis, the symptoms of which chronically fluctuate with remissions and relapses. Although a high psychosomatic and economic burden caused by atopic dermatitis is expected, few studies have been conducted estimating the cost of illness, including the self-medication costs and productivity loss due to atopic dermatitis. The aim of this study was to conduct a cross-sectional, Web-based survey of the direct medical costs, self-medication costs and productivity loss for adult atopic dermatitis patients, and estimate the burden of Japanese adult atopic dermatitis patients by disease severity. In a physician survey, the medical resource consumption related to medical treatments was surveyed by disease severity. The direct medical costs were calculated by multiplying the medical resource consumption and medical fee corresponding to each treatment. Based on the results of a patient survey, the self-medication costs and productivity loss were estimated by sex and disease severity. Atopic dermatitis-related productivity loss was calculated based on absenteeism, presenteeism, overall work impairment for employed workers and activity impairment for housewives. The nationwide estimations were calculated based on the estimated number of atopic dermatitis patients, employed workers with atopic dermatitis, and housewives with atopic dermatitis in their 20s-50s in Japan. Based on the surveys, all costs per patient and the scores increased with disease severity. The cost of illness for adult atopic dermatitis patients in Japan was estimated to be approximately JPY 3 trillion/year. Considering the physical and mental burdens, the burden of illness for adult atopic dermatitis was demonstrated to be vast.
特应性皮炎是一种瘙痒性、湿疹样皮炎，其症状随缓解和复发而呈慢性波动。尽管特应性皮炎会带来较高的身心和经济负担，但目前很少有研究估计疾病的经济负担，包括特应性皮炎的自付药物费用和因疾病导致的生产力损失。本研究旨在通过横断面、基于网络的调查，估算成人特应性皮炎患者的直接医疗费用、自付药物费用和生产力损失，并根据疾病严重程度估计日本成年特应性皮炎患者的负担。在医生调查中，根据疾病严重程度调查与医疗相关的医疗资源消耗。通过乘以每种治疗对应的医疗资源消耗和医疗费用，计算直接医疗费用。根据患者调查结果，按性别和疾病严重程度估算自付药物费用和生产力损失。根据缺勤、在职工作者的工作效率降低和家庭主妇的活动受限，计算特应性皮炎相关的生产力损失。根据日本特应性皮炎患者、有特应性皮炎的在职工作者和 20 多岁至 50 多岁的家庭主妇的估计人数，计算全国性估计值。根据调查，每位患者的所有费用和评分均随疾病严重程度的增加而增加。日本成人特应性皮炎患者的疾病经济负担估计约为 3 万亿日元/年。考虑到身心负担，成人特应性皮炎的疾病负担很大。
