345 The burden of atopic dermatitis out-of-pocket healthcare expenses in United States children

Atopic dermatitis (AD) is associated with elevated financial costs, including out-of-pocket (OOP) expenses. Yet, the full burden of OOP expenses in children AD poorly understood. We characterized categories, impact, and associations healthcare US children. An online survey was administered to National Eczema Association members (N=113,502). Inclusion criteria (US resident; respondent age ≥18; self or caregiver report diagnosis) met by 77.3% (1,118/1,447). Children (<18 yrs) vs. adults (≥18 had similar overall severity but increased provider (HCP) visits, comorbid food allergy, cutaneous infections, topical antimicrobial use (P<0.005 for all), hospitalization (4.6% 1.9%), emergency room visits (17.7% 12.1%), emollients (98.6% 93.1%), hygiene/bathing products (91.1% 83.3%), childcare (14.2% 2.8%), specialized cleaning (86.6% 71.6%), clothing/bedding (62.0% 40.3%) (P<0.05 all). median total yearly expenditures ($860 $500, P=0.002) were more likely spend ≥$1000 per year (48.9% 40.0%, P=0.03). In children, severity, flares, HCP prescription polypharmacy, step-up therapy reported similarly harmful household impact from (>60% each). Predictors among included black race (adjusted OR [95% confidence interval]: 3.86 [1.66-8.98] ≥$1,000 annual (6.98 [3.46-14.08], P<0.0001). have unique that are significant disease burden. Strategies needed reduce costs improve clinical outcomes AD.