The Impact of Atopic Comorbidities on Health Care Utilization for Atopic Dermatitis
Key Takeaways:
- Among young children with atopic dermatitis (AD), those who received systemic treatments (STs) had a higher prevalence of atopic comorbidities than those who received topical treatments.
- Patients receiving STs had higher rates of health care utilization than those receiving low-potency topical treatments (LTTs) and medium-to-high-potency topical treatments (MHTTs).
- The ST cohort accumulated the highest care costs, highlighting the substantial clinical and economic burden among patients with treatment resistence.
Treatment options for young children with AD are limited. Topical corticosteroids are a common therapy, although prolonged exposure may be associated with adverse side effects.
Study Methods and Outcomes
To evaluate the clinical and economic burden of AD among young children, researchers assessed health care utilization and care costs among children aged 6 months to younger than 6 years.
Using data from the IQVIA PharMetrics Plus Database, investigators identified 23 098 patients diagnosed with AD between July 2016 and December 2019. Patients were grouped into study cohorts according to treatment: LTTs, MHTTs, and STs.
Patient Characteristics
Among the 23 098 patients included in the study, 5452 received LTTS, 6778 received MHTTs, and 10 868 received STs.
Atopic comorbidities were more prevalent in the MHTT and ST cohorts, with the ST cohort having the highest prevalence. Patients in the ST cohort were also more likely to have eosinophilic esophagitis, allergic urticaria, and food allergies compared with other treatment groups.
Health Care Utilization and Care Costs
Patients receiving STs had significantly higher rates of health care utilization compared to those being treated with LTTs and MHTTs, especially for inpatient admissions (6.5% vs 1.5% and 1.5%) and emergency department visits (37.5% vs 22.0% and 22.0%). The ST cohort also had more outpatient visits than the LTT and MHTT cohorts (15.73 vs 10.82 and 10.75, respectively).
Consistent with higher health care utilization, the ST cohort accumulated higher care costs, which were primarily driven by medical costs. Total care costs were $9272.24 for the ST cohort, $5671.60 for the MHTT cohort, and $5249.69 for the LTT cohort. Similarly, AD-related care costs were higher in the ST and MHTT cohorts compared to the LTT cohort ($851.00 and $661.25 vs $586.72, respectively).
Implications for Managed Care
The findings suggest atopic comorbidities may be associated with increased health care utilization and care costs, as the ST cohort had the highest prevalence of comorbidities as well as the highest care costs.
The study also highlighted the limited therapy options available to children with AD, noting that systemic corticosteroids were frequently used despite recommendations against their routine use.
The authors said, “In this study, a substantial portion (almost half of the study population) used [systemic corticosteroids] despite well-documented safety concerns. Alternative treatment options, including biologics, should be considered for children with difficult-to-treat AD.”
Reference
Silverberg JI Martins B, Du M, et al. Healthcare resource utilization and costs in pediatric patients under 6 years old with atopic dermatitis in the United States: a retrospective, observational, cross-sectional study. JAAD Int. 2026;28:25-34. doi:10.1016/j.jdin.2026.04.025
