(105) Economic burden of moderate-to-severe chronic hand eczema in the United States: A retrospective claims analysis

Background: : Chronic Hand Eczema (CHE) is an inflammatory skin disease of the hands and wrists, marked by dryness, itchiness, pain, fissures, and blistering, and is defined as symptoms lasting ≥3 months or relapsing twice in a year. Despite its burden, no FDA-approved treatments are currently indicated for CHE and real-world data on its economic impact are limited.

Objective: : To assess the economic burden of moderate-to-severe CHE by evaluating healthcare resource utilization (HRU) and costs in the US.

Methods: : This retrospective claims study used Komodo Research Data (01/2016–04/2024). Adults with ≥1 SNOMED CT code for CHE or hand eczema (first observed: index date) and ≥1 ICD-10-CM code for eczema/dermatitis (L20.x; L23.x–L25.x; L30.x) were included. Moderate-to-severe CHE was defined by eczema-related systemic or phototherapy use, and patients were further categorized into non-mutually exclusive cohorts based on treatment(s) received at any time post-index: cohort 1 (≥2 systemic therapy claims; n=3,529), cohort 2 (≥1 claim for immunosuppressants, retinoids, monoclonal antibodies, or oral JAK inhibitors; n=551), and cohort 3 (≥1 claim for monoclonal antibodies or oral JAK inhibitors; n=239). Baseline characteristics were assessed in the 12-month pre-index period. Eczema-related HRU and costs were reported per patient per year (PPPY; 2023 USD) during treatment, from first prescription fill to last day of supply.

Results: : The study included 6,295 patients with moderate-to-severe CHE (mean age: 48.2 years; 63.8% female; 76.6% commercially insured). Comorbidities included allergic rhinitis (15.6%), asthma (12.3%), anxiety (21.0%), and depression (16.2%), with higher rates in cohort 3. Average treatment duration was 2 years in cohort 1 and 1.5 years in cohorts 2 and 3. Outpatient visits accounted for most eczema/dermatitis-related HRU, with 1.3, 3.0, and 4.7 visits PPPY in cohorts 1–3, respectively. Total eczema/dermatitis-related costs PPPY increased with treatment intensity, totaling $1,876 in cohort 1, $9,505 in cohort 2, and $21,682 in cohort 3. Pharmacy costs were the primary driver, contributing $1,221, $8,898, and $20,760 PPPY, respectively.

Conclusions: : This real-world analysis underscores the economic burden of moderate-to-severe CHE in the US, particularly among patients treated with monoclonal antibodies or oral JAK inhibitors. These findings highlight the need for effective, targeted treatments that reduce reliance on costly and potentially misaligned therapeutic escalation, especially in the absence of FDA-approved therapies specific to CHE.

Sponsorship:: LEO Pharma Inc.