Drug Eruptions by the Numbers

AMERICAN ACADEMY OF DERMATOLOGY SKIN DISEASE BRIEFS

Drug eruptions by the numbers

Drug eruptions are among 24 skin diseases or disease categories examined in the Burden of Skin Disease report commissioned by the American Academy of Dermatology. The report 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 and found that:

• 84.5 million Americans — one in four — were impacted by skin disease; 50% of them are over 65 and have an average of 2.2 skin conditions. • Skin disease cost the U.S. healthcare system $75 billion in medical, preventative, and prescription and non-prescription drug costs. • One in three Americans with skin disease were seen by a dermatologist, who collaborate with other physicians throughout the health care system in caring for these patients.

Drug eruptions on the skin primarily affected children and young adults, with those age 44 or younger accounting for approximately 62% of the more than 773,000 Americans who sought medical treatment in 2013. Drug eruptions:

• Cost patients an average of nearly $343 in 2013, surpassing the cost per patient for vitiligo, pruritus and urticaria combined, and non-cancerous skin growths. • Cost the health care system a total of $266 million and resulted in lost productivity costs of $44 million in 2013. • Caused more than 100 deaths in 2013, with patients lives potentially shortened by 11 years due to the disease.

The charts that follow provide topline data on how drug eruptions contribute to the overall burden of skin disease.

The full report includes data on prescription and non-prescription drug costs, and how age and insurance status and provider relate to the burden associated with drug eruptions and skin disease broadly. To purchase the report visit www.aad.org/BSD.

NUMBER OF CARED-FOR INDIVIDUALS DRUG ERUPTIONS OTHER SKIN DISEASES

30,000,000

25,000,000

20,000,000

15,000,000

10,000,000

5,000,000 773,369 0 NON-CANCEROUS VIRAL AND CUTANEOUS WOUNDS CONTACT DRUG SKIN GROWTHS* FUNGAL INFECTIONS AND BURNS DERMATITIS ERUPTIONS DISEASES

*This category is clinically broad in nature and includes, among other diseases: benign neoplasms, melanocytic nevi (unspecified), pilar cysts, pilonidal cysts (with or without abscess), scars and fibrosis, etc.

DRUG ERUPTIONS PATIENTS BY AGE*

45.0% 39.4% 40.0%

35.0%

30.0%

25.0% 23.2% 19.4% 20.0% 0.34% 18.0% 15.0%

10.0% 5.0%

0.0% 0-17 18-44 45-64 65+

*Percentage of drug eruption patients seen by a physician by age group.

TOTAL MEDICAL COST* DRUG ERUPTIONS OTHER SKIN DISEASES

$9,000 $8,135 $8,000 $7,015 $7,000 $6,398 $6,052 $6,000 $5,442 $5,000

$4,000

(IN MILLIONS USD) $3,000

$2,000

$1,000 $266 $0

CUTANEOUS NON-CANCEROUS WOUNDS SKIN ULCERS DRUG INFECTIONS SKIN GROWTHS** AND BURNS CANCER*** ERUPTIONS

*In millions of dollars compared to most costly skin diseases. **This category is clinically broad in nature and includes, among other diseases: benign neoplasms, melanocytic nevi (unspecified), pilar cysts, pilonidal cysts (with or without abscess), scars and fibrosis, etc. *** Represents combined data for melanoma and nonmelanoma skin cancer.

COST OF SKIN DISEASE PER AFFECTED PERSON* DRUG ERUPTIONS OTHER SKIN DISEASES

$3,500.00

$3,000.00

$2,500.00

$2,000.00

$1,500.00

$1,000.00

$500.00 $342.66

$0.00

CUTANEOUS SKIN ULCERS CONNECTIVE BULLOUS DRUG LYMPHOMA CANCER** TISSUE DISEASES DISEASES ERUPTIONS *Compared with most costly skin diseases. **Represents combined data for melanoma and nonmelanoma skin cancer.

MORTALITY* DRUG ERUPTIONS OTHER SKIN DISEASES 5,000

4,500

4,000

3,500

3,000

2,500 4,376

IN 2013 71.2 Y 2,000

1,500 NUMBER OF DEATHS NUMBER OF DEATHS 3,452 2,287 1,000 53.7 Y 73.5 Y 1,392 1,382 109 500 77.5 Y 57.8 Y 75.6 Y 0 SKIN WOUNDS CUTANEOUS ULCERS CONNECTIVE DRUG CANCER AND BURNS INFECTIONS TISSUE DISEASES ERUPTIONS

*Provides the total number of deaths and average age of death from drug eruptions compared with other skin diseases with highest mortality.

YEARS OF POTENTIAL LIFE LOST* DRUG ERUPTIONS TOTAL SKIN DISEASES ALL CAUSES OF DEATH

CONNECTIVE ALL CAUSES TOTAL WOUNDS AND CONGENITAL TISSUE DRUG OF DEATH SKIN DISEASES BURNS ABNORMALITIES DISEASES ERUPTIONS

7.9

10.8 11.6

18.7 20.2

22.9

*Estimate/projected number of life years lost due to drug eruptions as compared to top skin disease leading to early death; projected based on prototypical lifespan of 75 years.

LOST PRODUCTIVITY (OPPORTUNITY COST)* DRUG ERUPTIONS OTHER SKIN DISEASES

$2,500

$2,000 $1,924 $1,570 $1,413 $1,500

$940 $1,000

(IN MILLIONS USD) $699

$500 $44 $0

CUTANEOUS NON-CANCEROUS WOUNDS VIRAL AND CONTACT DRUG INFECTIONS SKIN GROWTHS** AND BURNS FUNGAL DERMATITIS ERUPTIONS DISEASE

*Time lost by patients and/or caregivers multiplied by average wages in 2013 ($192/day); In millions of dollars compared with skin diseases leading to the most loss of productivity. **This category is clinically broad in nature and includes, among other diseases: benign neoplasms, melanocytic nevi (unspecified), pilar cysts, pilonidal cysts (with or without abscess), scars and fibrosis, etc.

Copyright © 2017 by American Academy of Dermatology. All rights reserved. Copyright © 2017 by American Academy of Dermatology. All rights reserved. This information is intended for personal/noncommercial use and may not be reproduced in any form by any means (electronic, mechanical, or other) or held in any information storage and retrieval systems without written permission from the publisher.

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REV 05/05/2018 • 18-346