The cost of atopic dermatitis in the Netherlands: An international comparison

Background: Only a few international studies have assessed the economic burden of atopic dermatitis (AD), and no costs-of-illness study for AD has been done for the Netherlands. Objectives: To estimate the incidence, prevalence and health-care costs of AD in the Netherlands and to put these in an international perspective. Methods: We conducted a retrospective cohort study by using the data of an information system of general practitioners (GPs). To calculate the health-care costs at the primary care level we assessed medical resources utilization. We assessed the costs of patients with more severe AD from a retrospective study of patient files at the department of dermatology of a general hospital. We compared our results with costs-of-illness studies for other countries. Results: The overall general population incidence and prevalence of AD were 0.8% and 2.3%, respectively. The incidence and prevalence were high among children until the age of 6 years, respectively, 3.1% and 11.3%, but decreased rapidly thereafter. The total mean health-care costs per patient were US$71. The most significant costs were due to visits to the GP (US$32) and medication, mostly corticosteroids (US$21). Young children were treated more often with emollients alone. Only 7.8% of patients were referred to a specialist. The mean costs for these patients were US$186. Costs-of-illness studies for Australia, Germany, the U.K., the U.S.A. and the Netherlands suggested that the costs associated with AD vary considerably across countries. Estimates of the costs-of-illness for AD ranged from US$71 in the Netherlands to US$2559 in Germany per patient due to variation in the study population (GP vs. hospital) and the number of cost components included. Studies that included costs due to the time spent on treatment had relatively high estimates. Conclusions: The prevalence and incidence of AD are high among young children. In general, the health-care costs for AD were low. Patients' out-of-pocket costs were relatively high.