Health-related quality of life and economic burden of prurigo nodularis

J Am Acad Dermatol. 2022 Mar;86(3):573-580. doi: 10.1016/j.jaad.2021.05.036. Epub 2021 May 28.


Background: Prurigo nodularis (PN) is an understudied, pruritic inflammatory skin disease. Little is known about the effect of PN on quality of life and its associated economic burden.

Objective: To quantify the impact of PN on quality of life and its economic implications.

Methods: A cohort study of PN patients (n = 36) was conducted using the Health Utilities Index Mark 3 questionnaire. Control data from US adults (n = 4187) were obtained from the 2002-2003 Joint Canada/United States Survey of Health. Quality-adjusted life year loss and economic costs were estimated by comparing the Health Utilities Index Mark 3 scores of the PN patients with those of the controls.

Results: The PN patients had lower overall health performance compared to the controls, (mean ± SE, 0.52 ± 0.06 vs 0.86 ± 0.003, respectively, P < .001). In multivariable regression, PN was found to be associated with worse health performance (coefficient -0.34, 95% CI [-0.46 to -0.23]), most prominent in the pain subdomain (coefficient -0.24, 95% CI [-0.35 to -0.13]). This correlated to an average of 6.5 lifetime quality-adjusted life years lost per patient, translating to an individual lifetime economic burden of $323,292 and a societal burden of $38.8 billion.

Conclusion: These results demonstrate that PN is associated with significant quality-of-life impairment, similar to the level of other chronic systemic conditions. PN is also associated with a substantial individual economic burden, emphasizing the necessity of research on effective treatment options.

Keywords: chronic pruritus; disease burden; economic burden; epidemiology; health utility; itch; prurigo nodularis; pruritus; quality of life.

MeSH terms

  • Adult
  • Chronic Disease
  • Cohort Studies
  • Financial Stress
  • Humans
  • Neurodermatitis*
  • Prurigo* / complications
  • Quality of Life