Sleep disorders, anxiety and barriers: disability costs over 4,200 euros per patient

More than 190,000 Italians live with chronic spontaneous urticaria (CSU) in its moderate and severe forms – an inflammatory autoimmune condition that affects women twice as often as men and typically manifests between the ages of 20 and 40. CSU takes a toll on patients’ quality of life; they suffer from sleep disturbances, experience anxiety and depression, and face daily challenges at work and in their social lives. The hidden costs of the condition have been revealed by an Italian study published in the international scientific journal *Global & Regional Health Technology Assessment*¹, which involved 122 patients, over 70 per cent of whom had a severe form of the disease and an average age of around 46. The analysis involved expert economists, alongside the Association for Research and Treatment of Urticaria (ARCO) and Novartis, a leading innovator in the pharmaceutical sector, committed to working alongside all stakeholders in the national healthcare system to provide new solutions for those living with complex diseases, such as immunological conditions.

The results reveal that, each year, the indirect costs of CSU amount to an average of 4,200 euros per patient, rising to 5,200 euros for the most severe forms, largely due to lost working days (50 per cent) and reduced productivity (63 per cent) caused by the debilitating symptoms of CSU.

The findings of this survey complement those of a previous retrospective observational study carried out using healthcare databases, which examined approximately 5.5 million patient-years between 2016 and 2021, identifying and analysing 1,707 patients with a new diagnosis of CSU and an average age of 36. According to the survey, in the first year following diagnosis, almost 17 per cent of patients had, on average, 1.6 hospital admissions, and around 8 out of 10 patients had, on average, 2.4 visits to A&E and 3 specialist consultations during the year, demonstrating the burden of the disease in terms of healthcare utilisation, with an average annual direct cost of around 1,900 euros per patient borne by the National Health Service.

Another factor contributing to the socio-economic impact of CSU is the costs borne by patients, which, according to the study, amount to an average expenditure of around 500 euros, covering consultations and tests, medicines and other costs associated with the course of treatment. This financial burden is in addition to that borne by the National Health Service.

The study involved leading economists, including Chiara Bini, lead author of the scientific publication and researcher at CEIS-EEHTA, Faculty of Economics, University of Rome Tor Vergata, who comments: “Faced with a debilitating and often underestimated condition such as chronic spontaneous urticaria, it is a priority to analyse the costs borne directly by patients and by the wider community, in order to fully understand the real social and economic impact we are facing. This study has highlighted the extent to which CSU is a social challenge that deserves attention and commitment, for the benefit of patients and society as a whole.”