Study: AD and Out of Pocket Health Care Expenses


How are atopic dermatitis and out of pocket health care expenses related? This study aimed to find out.

A study published in Dermatitis investigated the association between atopic dermatitis (AD) and increased cost of out of pocket (OOP) expenses. The object was to characterize the impact of OOP health care expenses for AD.1

The researchers created an online survey comprised of 25 questions that was then given to National Eczema Association members. Inclusion criteria were United States (US) residents, aged 18 years or older with self-reported AD or a primary caregiver of an individual with AD were met by 77.3% of survey takers.

It was found that responders who had monthly OOP expenses of more than $200 were more likely to have increased AD severity, flares, health care provider visits, prescription polypharmacy, use of step-up therapy, frequent skin infections, and poorer disease control (P < .005 for all). Responders with OOP yearly costs of more than $1000 had similar associations and also had increased rates of comorbid asthma, allergic rhinitis, and anxiety/depression (P < .005 for all).

A total of 64.6% of participants reported harmful household financial impact of OOP expenses. Predictors of harmful impact included:1

  • Severe AD (adjusted odds ratio [95% confidence interval], 2.62 [1.11-6.19], P = .04);
  • Comorbid asthma (1.42 [1.07-1.87], P = .03);
  • 5 health care provider visits or more in a year (2.80 [1.62-4.82], P = .0007);
  • More than $200 OOP monthly expenditures (2.16 [1.45-3.22], .0006) and;
  • $1000 annual OOP expenditures or more (4.56 [3.31-6.27], P < .0001).

Authors concluded, “Out-of-pocket expenses for AD significantly impact household finances. Clinical interventions are needed to minimize OOP expenses while optimizing care outcomes.”


1. Chovatiya R, Begolka WS, Thibau IJ, Silverberg JI. Impact and associations of atopic dermatitis out-of-pocket health care expenses in the United States. Dermatitis. Published online September 27, 2021. doi:10.1097/DER.0000000000000795

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