Monoclonal antibodies, anxiety and work: the costs borne by families and the National Health Service
Given that this is a debilitating and frequently underestimated condition, it is essential to assess the costs it entails for patients and society as a whole
Chronic spontaneous urticaria is characterised by the spontaneous appearance of wheals (raised patches on the skin) accompanied by itching, angioedema (deeper tissue swelling) or both, lasting for more than 6 weeks, due to both known and unknown causes. There are not always identifiable triggers for chronic spontaneous urticaria, and the symptoms and signs can be unpredictable. Recent studies have reported that the prevalence of a diagnosis of chronic spontaneous urticaria is 0.5% in the general population. There are over 190,000 Italian patients suffering from moderate to severe forms of chronic spontaneous urticaria. The condition is most common in patients aged between 20 and 40, but can be observed in all age groups and lasts on average for 2 years. Studies have consistently shown that women are almost twice as likely as men to develop the condition.
The impact on quality of life
Chronic spontaneous urticaria has a huge impact on a person’s quality of life, mainly due to skin rashes, swelling, itching, a feeling of exhaustion and, in some cases, pain. Sleep disturbances can also lead to poor health, often caused by the itching associated with urticaria. Patients often report significant repercussions on their social and interpersonal relationships, with a reduction in socialising with friends and relatives and in visiting public places. Mental health may be compromised because the unpredictability of the skin rashes can induce a state of anxiety, making patients easily irritable, listless and more prone to certain painful conditions such as headaches. Patients also report emotional and social difficulties relating to family life, personal care, leisure or social activities, and mobility.
Costs covered by the NHS
Chronic spontaneous urticaria undoubtedly has a significant economic impact on both patients and the National Health Service, particularly in its moderate and severe forms.
For patients, the financial burden relates to the costs of specialist allergy and dermatology consultations and regular check-ups; the costs of diagnostic tests, the purchase of medication and, in some cases, the use of private healthcare services to reduce waiting times. For a number of patients, the costs associated with using healthcare services for related psychological issues must also be taken into account.
Furthermore, in the case of patients, consideration must also be given to the loss of working days or reduced productivity (presenteeism) caused by itching, insomnia and flare-ups of the condition, as well as transport costs and the costs of care provided by family members.
