Disease burden of patients with pemphigus from a societal perspective

ABSTRACT

Introduction: Cost-of-illness studies are widely used for healthcare decision-making; however, no such study is available in pemphigus from the societal perspective. The purpose of this analysis was to estimate annual cost-of-illness per patient with pemphigus from a societal perspective.

Areas covered: Between 2014 and 2017, a multicenter, cross-sectional study was carried out. Consecutive pemphigus patients aged ≥18 years were recruited at all four university dermatology departments in Hungary. Direct and indirect costs were calculated, including costs for treatments, outpatient visits, hospital admissions, informal care, travel costs and productivity loss. Generalized linear model was used to analyze predictors of costs. Atotal of 109 patients with pemphigus enrolled with amean age of 57.1 (SD 14.8) years. Total cost per pemphigus patient was €3,995 (SD €7,526) peryear, with productivity loss (58%) and informal care (19%) accounting for the majority. Annual means of 189 and 41 working hours were lost due to absence from work and reduced productivity, respectively. Younger age and pemphigus vulgaris were associated with higher costs (p < 0.05).

Expert opinion: This is the first cost-of-illness study applying the societal perspective in pemphigus. Our results indicate a substantial economic burden on society, mainly driven by productivity loss and informal care.

KEYWORDS:

• Pemphigus vulgaris
• pemphigus foliaceus
• cost-of-illness
• cost analysis
• absenteeism
• presenteeism

Article Highlights

• This is the first cost-of-illness study in pemphigus from Europe.

• In a biological-naïve patient population, the estimated mean total cost per pemphigus patient was €3,995 per year in Hungary.

• Productivity loss and informal care were accounting for the majority of costs.

• More severe disease, younger age and pemphigus vulgaris were associated with higher costs.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

• Conception and design: VB, MS, ASZ, MP, LG, RF

• Acquisition, analysis and interpretation of the data: VB, BT, KH, ASZ, ZBCS, ÁJ, RF

• Drafting of the paper: VB, RF

• Revising it critically for intellectual content: BT, KH, MP, ASZ, MS, ZBCS, ÁK, LG

• Final approval of the version to be published: VB, BT, KH, MP, ASZ, MS, ZBCS, ÁK, LG, FR

Data Availability Statement

The data that support the findings of this study are available on request from the corresponding author, V Brodszky. The data are not publicly available due to information that could compromise the privacy of research participants.

Supplementary material

Supplemental data for this article can be accessed here.

Additional information

Funding

This paper was funded by the Higher Education Institutional Excellence Program of the Ministry for Innovation and Technology in Hungary in the framework of the ‘Financial and Public Services’ research project (NKFIH-1163-10/2019) at the Corvinus University of Budapest.