Burden of Skin Disease shows economic impact of skin disease

dr-henry-w-lim-md.jpgBy Henry W. Lim, MD
Academy president and chair of the Burden of Skin Disease Work Group

In 2016, the AAD embarked on a research study that looked at the effects of having skin disease on the United States patient population, and to provide an up-to-date analysis of the burden of skin disease that reflects these recent changes in the practice of medicine.

Since the publication of the last U.S. national burden of skin disease report in 2006, there have been substantial changes in the practice of dermatology and the U.S. health care system. These include the development of new treatment modalities, marked increases in the cost of medications, increasingly complex payer rules and regulations, and an aging of the U.S. population.

The Academy is creating briefs on the 24 skin disease categories examined in the 2016 Burden of Skin Disease report. The briefs are complimentary and available for informational purposes only.

Recognizing the need for up-to-date data to inform researchers, policy makers, public stakeholders, and health care providers about the impact of skin disease on patients and U.S. society, the AAD produced a new national burden of skin disease report. Using 2013 claims data from private and governmental insurance providers, this report analyzed the prevalence, cost, and mortality attributable to 24 skin disease categories in the U.S. population.

On March 1, the Journal of the American Academy of Dermatology (JAAD) published the first in a series of three articles on the report. In the first article, the presented data demonstrate that nearly 85 million Americans were seen by a physician for at least one skin disease in 2013. This led to an estimated direct health care cost of $75 billion and an indirect lost opportunity cost of $11 billion. Further, mortality was noted in half of the 24 skin disease categories. This highlights the fact that dermatologists treat diseases that potentially can have very significant health consequences.

Key findings include:

  • Skin disease is serious and can be deadly.
    • Of the 24 skin disease categories analyzed in the study, half are associated with mortality.
    • Nonmelanoma skin cancer and melanoma accounted for 60 percent of skin disease-related deaths.
  • Prevalence of skin disease is high and is likely to increase as the population ages.
    • The number of individuals with skin disease across the U.S. population in 2013 exceeds those with cardiovascular disease, diabetes or end-stage renal disease.
    • One in four Americans (26 percent) reported receiving treatment for at least one skin disease in 2013.
    • Nearly 50 percent of Americans over age 65 have skin disease, with an average of 2.2 skin diseases each.
  • Skin disease burdens Americans, their families and employers.
    • $75 billion was spent on skin disease in 2013. The majority of this was for treatment costs, including $46 billion for health care provider costs from medical care.
    • Patients and caregivers with skin disease suffered $11 billion in lost productivity. (This does not include additional time for at-home care and treatment, which was not evaluated.)

A new website features resources on the Burden of Skin Disease including complimentary briefs and the opportunity to license the full report.

Burden of Skin Disease website

The Academy has launched a website that offers resources related to the report, including:

The report is being released in conjunction with the Academy’s new SkinSerious campaign, which aims to raise awareness of the impact of skin disease, as well as the critical role dermatologist play in the era of team-based care.

Report includes analysis of 24 disease categories

The 2016 Burden of Skin Disease report, commissioned by the American Academy of Dermatology, examined prevalence, economic burdens, and mortality for skin disease in the U.S. using 2013 health care claims data drawn from insurance enrollment and claims databases. The scope of this analysis was to study the burden of skin disease relevant to the practice of dermatology, as well as to other providers treating the skin.

The full Burden of Skin Disease report includes analysis of 24 disease categories:
 1. Acne (cystic and vulgaris)
2. Actinic damage
3. Atopic dermatitis, eczema
4. Benign neoplasms, keloids, scars, cysts
5. Bullous diseases
6. Congenital abnormalities (including hemangiomas)
7. Connective tissue diseases
8. Contact dermatitis (including occupational)
9. Cutaneous infections (including impetigo, cellulitis, abscesses, and other bacterial or mycobacterial infections)
10. Cutaneous lymphoma
11. Drug eruptions
12. Hair and nail disorders
13. Human papillomavirus (HPV) infections/warts and mollusca contagiosa
14. Melanoma
15. Non-melanoma skin cancer
16. Pruritus
17. Psoriasis
18. Rosacea 
19. Seborrheic dermatitis
20. Ulcers
21. Urticaria
22. Viral (herpes simplex [HSV] and herpes zoster [HZV]) and fungal diseases
23. Vitiligo
24. Wounds and burns