Economic Burden of Chronic Urticaria in Brazil: A One-Year Real Life Study

The costs of chronic urticaria (CU) are not known in Brazil. The objective of this study is to describe costs related to its treatment in a defined setting. A longitudinal descriptive study of patients with spontaneous CU and/or inducible CU (INDCU), who performed 4 visits for primary data collection of clinical and socio-demographic variables and direct and indirect costs, during a 12-month period. Patients with other skin symptoms/signs and those who discontinued treatment were excluded. All were subjected to challenge tests for INDCU, objective evaluation and treatment according to the most recent guidelines. The project was submitted and accepted by the Ethics Committee, and all patients signed an informed consent form before inclusion. In the period between November 2016 to December 2018, 68 patients were evaluated, of which 55 completed the protocol. The mean age was 39 years (SD ± 20), duration of disease 66 months (SD ± 37), time of diagnostic 24 months (SD ± 13) and follow-up time of 18 months (SD ± 12). Chronic spontaneous urticaria (CSU) was diagnosed in 24 (43%), CSU+INDCU in 21 (38%) and only INDCU in 10 (18%). Angioedema was present in 24 (43%) patients. The mean family income was US$ 1,428.09 (SD ± 1,571.71). Absenteeism related cost of workers and those responsible for minors was US$ 21,125.84 (US$ 384.10 patient-year, SD ± 2,127.01). The transportation cost was US$ 3,755.69 (US$ 68.28 patient-year, DP ± 77.00). The total indirect cost was US$ 24,881.53 (US$ 452.39 patient-year, SD ± 461.11). Expenses with outpatient/urgent and non-medical visits were US$ 3,838.17 (US$ 69.78 patient-year, DP ± 112.09). The total cost of complementary tests was US$ 6,607.39 (US$ 120.13 patient-year, SD ± 63.81). The cost of drugs was US$174,697.58 (US$ 3,176.31 patient-year, SD ± 6,271.71), and US$ 141,582.91 was related to the use of omalizumab in 12 patients. The direct cost was US$ 185,143.15 (US$ 3,366.23 per patient-year, SD ± 6,446.58). The total cost was US$ 210,024.67 (US$ 3,818.62 patient -year). The cost related to CU was comparable to that estimated with outpatient asthma treatment at the same clinical setting with the cost associated with medications being the highest, and a significant impact by the use of omalizumab.