Prevalence of Atopic Dermatitis in the United States, 2019–2023: National, State, and County-Level Estimates from Administrative Claims Data

BACKGROUND/OBJECTIVE: The prevalence of diagnosed atopic dermatitis (AD) and associated patient and treatment characteristics have not been comprehensively investigated in the United States of America (USA), especially at the state and county levels. Evaluating geographic distribution, treatment utilization, and disease characteristics at a more granular level can enhance the understanding of disease burden and aid in the identification of areas with unmet needs. The aims of the study were to describe the prevalence of AD, the associated medical conditions, and filled prescription medications for patients with diagnosed AD in the USA at the national, state, and county levels. METHODS: Longitudinal Access and Adjudicated Data database, individuals with ≥ 1 ICD-10-CM AD diagnosis code between 1 January 2019 and 31 December 2023 (index period) were identified. Age- and sex-standardized prevalences were calculated at national, state, and county levels. Geographic location was inferred from the healthcare provider's zip code. Demographics and treatments were assessed during the 365-day baseline period. RESULTS: A total of 5,573,454 patients were identified with an AD diagnosis during the index period. Median age of patients with diagnosed AD was 18 years (interquartile range, 6-49); 57.1% of patients were female, 38.3% were children (0-11 years old), 11.4% were adolescents (12-17 years old), and 50.2% were adults (≥ 18 years old). Nationally, the prevalence of diagnosed AD was 2.4%; age-standardized prevalence was 2.2% in males and 2.6% in females. Prevalence was highest in children (7.2%), followed by adolescents (3.6%) and adults (1.4%). State-level prevalence ranged from 1.3% (Missouri) to 4.5% (Washington, DC). At the county level, AD prevalence ranged from 0 to 19.6%. Prescriptions filled during the baseline period included topical (56.3%) and oral (22.6%) corticosteroids, biologics (2.8%), and oral JAKis (0.2%). During the 6-month postindex period, topical (27.6%) and oral (11.6%) corticosteroids remained the most frequently filled prescriptions; biologics (2.8%) and oral JAKis (0.2%) were less frequently filled. CONCLUSIONS: Using a large open-claims database, distinct variations in AD prevalence between age groups and geographies were identified. Differences in the low use of biologics and oral JAKis with high corticosteroid use were observed nationally.