Introduction Real-world data on the epidemiology and economic burden of atopic dermatitis (AD) are limited. Here we describe the epidemiology and economic burden of AD using electronic healthcare data from Israel. Methods A retrospective study was performed using the Maccabi Healthcare Services database. AD incidence in 2008–2017 and point prevalence (AD_prev) on 31 December 2017 were described using diagnosis codes for overall patients, and sex and age subgroups. For AD_prev, severity was defined using recently dispensed treatments for AD. Annual healthcare resource utilization in AD prevalent patients was compared with non-AD matched controls using generalized linear modelling. Direct annual costs were estimated also. Results AD incidence was 7.0/1000 person-years; overall prevalence was 4.4% (female patients 4.5%, male patients 4.3%; age 0 to less than 6 months, 0.9%; 6 months to less than 12 years, 11.0%; 12 to less than 18 years, 5.8%; 18 years or older, 2.2%). Among AD_prev (n = 94,483), mild, moderate, and severe AD comprised 57.7%, 36.2%, and 6.1% (adults 43.8%, 46.3%, 9.9%), respectively. Dermatologist and allergist visits and hospitalization rates (at least one) were 40.7%, 6.6%, and 3.8% in 2017. Compared with controls, overall and moderate-to-severe AD were associated with 36% and 52% increases in annual per-person costs (incremental costs $126 and $190). Conclusions AD epidemiology in Israel is comparable with other real-world database studies. AD imposes an economic burden that increases with disease severity.

Introduction Patients with atopic dermatitis (AD) have a high atopic comorbidity burden. Although traditionally seen as beginning with AD and progressing to other atopic comorbidities, the “atopic march” model does not fit all patients. This manuscript describes the onset of atopic comorbidities among children newly diagnosed with AD. Methods This retrospective, observational, cohort study used data from the Israeli Maccabi Healthcare Services. Patients (< 18 years) first diagnosed with AD during 2000–2019 with ≥ 12-month enrollment before and after AD diagnosis were included. Outcomes included cumulative asthma, allergic rhinitis (AR), and food allergy (FA) prevalence. Patients were grouped by age at AD diagnosis (< 3, 3–5, 6–11, and 12–17 years). Results Of 177,081 included patients, 60.4% were < 3 years old at AD diagnosis. The baseline asthma prevalence (at or before AD diagnosis) was lower in children aged < 3 versus ≥ 3 years at AD diagnosis (10.6% versus 26.3–28.5%). The baseline AR prevalence increased with age from 2.2% (< 3 years) to 23.2% (12–17 years), while FA decreased from 4.9% (< 3 years) to 2.1% (12–17 years). Cumulative asthma and FA prevalence increased sharply in the year following AD diagnosis among children diagnosed at < 3 years old. The cumulative ≥ 1 asthma/AR/FA prevalence increased to approximately 50% by 10 years after AD diagnosis. Conclusions Children diagnosed with AD at an early age mostly acquire atopic comorbidities within 1 year following AD diagnosis, while children diagnosed later have often already developed them. Eventually, all pediatric patients with AD display a similar, significant burden of atopic multimorbidity. Graphical abstract available for this article. Trial Registration Not applicable.