Background: Alopecia areata is a skin disease that affects patients’ quality of life and social participation and it exerts an economic burden of patients and implicitly their family. To date, this is the first study to quantify the economic burden of alopecia areata for both pediatric and adult patients. Objective: This cost of illness study seeks to quantify the economic burden of alopecia areata for patients aged <20 years and 20+ years for both mild and severe forms of alopecia areata using retrospective and prospective data sources, both incidence and prevalence-based approaches. This cost of illness study is mixed as it employs both top-down and bottom-up approaches. Results: The results of this cost of illness study show that for adults, for both prevalence and incidence-based approach, the highest costs are the direct costs attributable to medical services and associated costs, and the indirect costs due to work absenteeism. Regarding the pediatric population segment, the highest costs were due to treatment, associated expenses and productivity costs inquired by caregivers. Conclusion: This is the first study to quantify the burden of alopecia areata in Romania, for both pediatric and adult patients. Our study highlights that out-of-pocket costs pose an immense burden on patients and their caregivers. Our estimations emphasize that patients with AA should be considered when planning health services delivery and health services and medicine reimbursement.

Introduction: Atopic dermatitis (AD), a common dermatological condition, is often associated with significant economic and social burdens. Despite extensive studies globally, there is a gap in understanding the impact of this condition in Romania. This study evaluated the economic burden of AD in Romania, considering both direct and indirect costs. Materials and methods: A cost of illness study, conducted from a broad perspective, considering 2022 as a reference, using top-down and bottom-up approaches and retrospective and prospective data sources was used to assess direct medical costs (treatments, medical services, hospitalizations), direct non-medical costs (associated costs due to transportation, accommodation), and indirect costs (productivity losses) across four costing scenarios. Results: In 2022, the total cost of atopic dermatitis in Romania was €29,810,077.2 for adult patients and €133,635,535.2 for pediatric patients, based on a prevalence-based approach, and €5,529,867.8 for adults and €53,175,049.1 for pediatric AD patients when using an incidence-based approach. Medical costs had the highest attributable share of the AD cost for adult patients while productivity costs (inquired by caregivers) had the highest share for pediatric AD patients in both approaches. T he overall average annual cost per patient ranged, depending on the scenarios, between €284.72 and €1,045 for adult AD patients and between €293.73 and €9,558.52 for pediatric AD patients. Discussion: Our results show the increased burden among pediatric AD patients emphasizing the need that future policy interventions should be tailored according the patients’ age.