Stirnadel-Farrant HA, Xu X, Kwiatek J, Jain P, Meyers J, Candrilli S, Mines D, Datto CJ. Characteristics, treatment patterns, healthcare resource utilization and costs in patients with bullous pemphigoid: a retrospective analysis of US health insurance claims data. J Am Acad Dermatol. 2023 Dec;13:117-25. doi: 10.1016/j.jdin.2023.04.014

BACKGROUND: Real-world data describing the impact of incident bullous pemphigoid (BP) on patients and healthcare resource utilization (HCRU) are limited.

OBJECTIVE: To examine characteristics, treatment patterns, HCRU, and costs for incident BP.

METHODS: Retrospective analysis of 2015–2019 US health insurance claims for patients ≥18 years with an incident BP diagnosis. Patients with BP were matched to those without on demographic and clinical characteristics. Statistics were descriptive.

RESULTS: Mean Charlson Comorbidity Index score was higher for patients with BP (n=1,108) than without (n=4,621) at baseline (mean [standard deviation (SD)]: 3.3 [2.7] vs 2.8 [2.4]) and during follow-up (5.0 [4.9] vs 3.7 [3.0]). Hypertension, diabetes, skin ulcers, chronic pulmonary disease, dyslipidemia, sleep disorders, and congestive heart failure were higher with BP. Most patients with BP received antibiotics (>80%) and/or corticosteroids (>90%). Hospitalizations were more common (44.0% vs 17.1%) and monthly all-cause healthcare costs more than double ($3,214 vs $1,353) in patients with BP than without.

LIMITATIONS: Diagnoses were based on billing codes. HCRU claims data may not reflect the true number of encounters.

CONCLUSION: Incident BP is associated with considerable morbidity, HCRU, and costs. More effective, targeted treatments are needed to improve quality of life, while minimizing exposure to systemic corticosteroids.

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