1. The Burden of Skin Disease in the United States Wendy Smith Begolka, MBS Associate Director, Science & Research

2. A Contemporary Report
Previous Burden of Skin Disease Report developed in 2004
The past 10 years have seen significant changes that may impact skin disease burden
Practice of dermatology
Treatment advances
Healthcare policy
Evolving U.S. population

3. Burden of Skin Disease Resources
Manuscripts
Briefs
Report

4. Broad Representation of Skin Disease
SKIN CATEGORIES
Acne
Contact dermatitis
Benign neoplasms/
keloids/scars/cysts
Non-melanoma
skin cancer
Actinic keratosis
Cutaneous infections
Melanoma
Ulcers
Atopic dermatitis
Cutaneous lymphoma
Pruritus
Wounds and burns
Bullous diseases
Drug eruptions
Psoriasis
Urticaria
Congenital abnormalities
Hair and nail disorders
Rosacea
Vitiligo
Connective tissue diseases
HPV / molluscum
Seborrheic dermatitis
Viral and fungal diseases

5. Claims-Based Assessment of Burden
PREVALENCE
Portion of population having at least one skin disease diagnosis recorded on a health insurance claim during 2013

6. Key Insights from the BSD Report
Skin Disease is Common
Skin Disease has High Economic Impact
Direct costs:
Societal, Personal
Indirect costs:
Lost opportunity (work, school)
Skin Disease is Serious
Mortality

7. One in Four Americans Have Skin Disease
84.5 million Americans (~27% of population) treated for skin disease in 2013
For those > age 65: 50% treated for skin disease
Avg. 2.2 diseases per person
* Average number of skin diseases

8. Skin Disease Incidence with Age
3.1 million
14.5 million
18.0 million
18.0 million
4.8 million

9. Economic Burden of Skin Disease
$75 billion in 2013
Care by health care providers: $46 billion
Prescription drugs: $15 billion
Over-the-counter treatments: $10 billion
$46 billion more compared to 2004
Total Direct Costs (in $1,000,000s)

10. Medical Costs Vary By Skin Disease

11. …as do Per Affected Person Costs
Average Cost of Skin Disease:
Per Affected Person = $887
Per US Capita = $240

12. Impact of Prevalence on Total Costs
Prevalence does not always correlate with total costs
Skin diseases with lower prevalence can have substantial economic impact

13. Skin Disease and Loss Productivity
Skin disease categories with higher loss productivity correlate with those with higher prevalence
Report was unable to assess Quality of Life aspects of disease burden
Loss productivity
~ $11 billion
2013 average hourly wage was $23.97 or $ per 8 hour day
The significant economic impact of skin disease can also be assessed by looking at more indirect measures of cost and skin disease care—this graph shows lost opportunity costs.
Every encounter with the healthcare system requires time:
time that the patient and often the patient’s parent(s), spouse, partner, or other caregiver would have had the opportunity to use for other purposes, including work or school—for children the opportunity cost is often the parents’ opportunity cost.
The report estimated patient-days of interaction with the healthcare system and assigned a value to it using the hourly wage shown here.
Although not all 24 skin diseases are shown on this graph – in total they result in $11 billion in loss productivity. This is in additional to the $75 billion dollars in direct costs shown previously.
Unfortunately the report was unable to assess other indirect measures of skin disease burden—largely that would fall into the quality of life category – as there is not currently a consistent way to do this across all skin disease. This is an area for future study and assessment.

14. Skin Disease is Serious
Half of skin categories analyzed were associated with mortality
Life expectancy decreased by 5 years for those with fatal diseases
Skin cancers = 60% of skin-related deaths

15. Dermatologists and Management of Skin Disease
1 in 3 patients with skin disease: treated by dermatologists
An estimated 20,000 dermatology clinicians would have been needed to treat skin disease in 2013
Access to dermatologists and other dermatology providers is critical for skin disease prevention and treatment

16. Merging BSD and Patient Stories
Use real stories and the Burden of Skin Disease data to raise awareness of:
The breadth and seriousness of skin conditions
The critical role dermatologists play, working in partnership with other physicians
Dermatologists’ efforts to increase access to care