Costs, Comorbidity Burden High in US Patients With Hidradenitis Suppurativa

Health care costs are high in US adults and adolescents with hidradenitis suppurativa (HS), and the comorbidity burden in patients with the chronic skin condition appears to grow over time, according to a study published online ahead of print in the American Journal of Clinical Dermatology. 

“Even though this study was performed after biologic therapy was approved for HS in the United States (2016–2018), this analysis showed that most patients are managed on topical therapies and systemic antibiotics,” wrote corresponding author Amit Garg, MD, of the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, New York, and study coauthors. “Indeed, the level of antibiotic use (systemic and topical) was higher in adolescents than adults, which might be because physicians are more reluctant to escalate treatment in the adolescent population.” 

Among the 10,230 adults and 628 adolescents with HS included in the retrospective cohort study, 65.1% of adults and 74.5% of adolescents were treated with systemic antibiotics, and 25% of adults and 41.7% of adolescents were treated with topical antibiotics. Just 3.5% of adults and 1.8% of adolescents were prescribed biologic therapy. 

The real-world study also looked at disease burden and health care resource use in patients.  

Before HS diagnosis, common Charlson comorbidities in adults were diabetes without complications (20.4%), chronic pulmonary disease (16.4%), and diabetes with complications (9%), according to the study. Common Elixhauser comorbidities in adults were uncomplicated hypertension (38.3%), obesity (22.5%), uncomplicated diabetes (19%), and depression (17.4%). In both adults and adolescents, the comorbidity burden tended to increase after HS diagnosis. 

In the 2 years after HS diagnosis, total health care costs were US$42,143 for adult patients and US$16,057 for adolescent patients, the study found. Outpatient care comprised the majority of the costs: US$20,980 for adults and US$8408 for adolescents. 

“Patients with HS may require comprehensive care strategies involving a multidisciplinary team of physicians to improve health while reducing health care expenditures,” researchers advised.  

Reference 
Garg A, Geissbühler Y, Houchen E, et al. Disease burden and treatment patterns among US patients with hidradenitis suppurativa: a retrospective cohort study. Am J Clin Dermatol. Published online June 28, 2023. doi:10.1007/s40257-023-00796-2