Costs of AD High Among Patients With Medicaid

The cost for treating atopic dermatitis (AD) varies based on whether patients have commercial insurance or Medicaid, according to a poster study presented at the 2019 American Academy of Dermatology Annual Meeting. Those with Medicaid have higher costs and more emergency department (ED) visits compared with those with commercial insurance.

“AD is a chronic, highly symptomatic inflammatory skin disease in both children and adults characterized by skin manifestations and pruritus,” the researchers noted.

The retrospective analysis included 511,767 patients with AD enrolled in the Truven Marketscan database, of whom 468,021 had commercial insurance (91.5%), including those with Medicare supplement, and 43,746 had Medicaid (8.5%). Researchers calculated inflation-adjusted costs and proportion of patients who required hospitalization, ED visits, and outpatient visits among those with commercial insurances compared with Medicaid over a 3-year period.

Outpatient costs were similar between patients with commercial insurance and those with Medicaid. However, those with Medicaid were more likely to require hospitalization (11% vs 7.5%) or visit the ED (51.9% vs 21.1%) compared with those with commercial insurance. These trends were observed throughout the 3-year follow-up, the researchers noted.

Patients with commercial insurances were more likely to visit a dermatologist or allergist (58.3% and 6.9%, respectively) within the first-year post-index date compared with those without Medicaid (11.1% and 3.3%).

In addition, the researchers observed consistently higher costs among patients with Medicaid compared with those with commercial insurance across different age groups. The total annual adjudicated cost for patients with commercial insurance was between $10,607 and $11,477 per patient, with outpatient services accounting for half of the total cost. Whereas, the total annual adjudicated claims cost was between $12,648 and $12,791 per patient among those with Medicaid.

“These data identify significant health disparities involving the Medicaid population, reflected by poor access to specialty care and more ED visits with overall increases across age groups,” the researchers concluded. “Better outpatient AD care focusing on proper patient education and long-term disease control is warranted, which may reduce ED visits, hospitalization, and health care expenses overall and potentially increase work productivity.” —Melissa Weiss