The Worse it Gets, the More We Spend: New Findings Show Atopic Dermatitis Out of Pocket Costs Tied to Severity of the Disease


By Steve Nelson

Published On: Sep 13, 2021

Last Updated On: Sep 13, 2021

The NEA research team has published its second paper in Dermatitis on the out of pocket (OOP) costs of atopic dermatitis (AD) in the United States. The first publication can be found here and summarized in this blog story

Based on a survey of NEA’s eczema patient and caregiver community, this body of research is the first to examine the OOP financial burden facing Americans living with AD from the patient perspective. The findings have been analyzed in collaboration with researchers Raj Chovatiya, MD, PhD (Northwestern University) and Jonathan Silverberg, MD, PhD, MPH (The George Washington University School of Medicine and Health Sciences).

Disease OOP Costs Correlate to Disease Severity

In the newest published findings, the team correlates higher OOP costs to the severity of disease, determining that Americans living with increased OOP expenses related to eczema are more likely to experience increased disease intensity, more frequent flares, poor disease control, more frequent HCP office visits and increased rates of comorbid conditions such as asthma, allergic rhinitis and anxiety/depression. 

Specifically, patients spending more than $100 monthly in OOP to treat their AD were more likely to report minimal disease control (41.1%), the use of three or more prescription medications (39.7%), and the use of step-up therapies (42.3%) such as injectable and oral medications or phototherapy. Nearly 40% of these respondents also reported that they had spent more than 11 days actively flaring in the preceding month. Multiple data points converge to demonstrate a significant correlation between increased OOP cost and increased disease severity.

Impact of OOP Expenses on Families and Caregivers

Details from the new study also demonstrated that 24.5% of respondents indicated that OOP expenses related to AD had a significant or devastating impact on their personal or family finances, while 40.1% of respondents reported that AD-related OOP expenses had at least moderate impact on their finances. Respondents who reported a higher degree of moderate,  significant or devastating financial burden were more likely to have increased AD severity, poorer control of their condition, more days spent actively flaring and more visits to their healthcare provider. In fact, the data demonstrate that severe AD is a positive predictor of harmful financial impact on the individual and/or family with the condition.

These findings highlight the significant burden that OOP costs can place on AD patients and caregivers, especially those who are managing the most severe forms of AD.  These insights are however important information for people living with AD of all severities, to enhance conversations with health care providers around establishing treatment plans that are sensitive to both financial and clinical considerations for a complex and heterogeneous disease.  

NEA’s research program is made possible through the participation of patients and caregivers. Learn about our ongoing efforts and see what surveys are ready for your input at

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