On the economic burden of alopecia areata in Romania
11 affiliations
- 1Department of Dermatology, “Saint Parascheva” Infectious Disease Clinical Hospital, Galați, Romania
- 2Department of Clinical Medical, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galați, Galați, Romania
- 3Multidisciplinary Integrated Centre of Dermatological Interface Research (MICDIR), “Dunărea de Jos” University of Galați, Galați, Romania
- 4Dermatology Department, Colentina Clinical Hospital, Bucharest, Romania
- 5Faculty of Medicine, Titu Maiorescu University, Bucharest, Romania
- 6Asociația Pacienților cu Afecțiuni Autoimune (APAA), Bucharest, Romania
- 7National Institute for Management of Health Services, Bucharest, Romania
- 8RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
- 9Research Center for Functional Genomics, Biomedicine and Translational Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
- 10Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- 11EgoClinic - Institute of Dermatology, Bucharest, Romania
Abstract
Introduction: Alopecia areata (AA) is an immune-mediated disorder that substantially impairs quality of life, social participation, and work productivity while generating considerable healthcare costs. Data regarding its economic burden in Romania are currently lacking.
Methods: We conducted a societal-perspective cost-of-illness study for the reference year 2022, combining a cross-sectional online survey of patients and caregivers (41 adult patients and 7 caregiver proxies, of whom 4 reported for pediatric patients) with four national secondary data sources: alopecia areata-specific epidemiological estimates from the Global Burden of Disease (GBD) 2021 study, pharmaceutical market data (IQVIA), hospitalization cost and discharge statistics, and national labor statistics. Survey-derived unit costs were extrapolated to the national level using both prevalence- and incidence-based approaches, combining bottom-up (treatment, medical services, associated expenses), top-down (hospitalizations), and hybrid (productivity losses) costing. Health-related quality of life was assessed with the EQ-5D-5L.
Results: The estimated total cost of alopecia areata in Romania in 2022 was EUR 97.95 million for adults and EUR 3.35 million for pediatric patients under the prevalence-based approach, and EUR 170.56 million and EUR 6.37 million, respectively, under the incidence-based approach. In adults, productivity losses (45.2–51.2%) and associated out-of-pocket expenses (28.5–32.2%) were the largest contributors, followed by medical services and treatment. Among pediatric patients, associated expenses, caregiver productivity losses, and treatment were the main cost drivers. Average annual cost per adult patient was EUR 2,608.6, and was higher for mild (EUR 3,248.3) than for severe disease (EUR 1,999.4). Problems with anxiety/depression were the most frequently affected EQ-5D-5L dimension (77.8% of adult respondents; 6 of 7 caregiver proxies).
Discussion: This is the first study to estimate the economic burden of alopecia areata in Romania. Although the survey sample was small and self-selected, the combination of patient-reported unit costs with national epidemiological and administrative data allowed national burden estimates under transparent assumptions. The findings highlight the substantial societal cost of alopecia areata — driven primarily by productivity losses and out-of-pocket spending rather than by reimbursed care — and support its consideration in healthcare resource allocation and service planning. Larger, representative studies are warranted to validate these estimates.
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BibTeX
@article{olaru2026economic,
title = {{On the economic burden of alopecia areata in Romania}},
author = {Mihaela Olaru and Alin Laurentiu Tatu and Rodica Olteanu and Rozalina Lapadatu and Cristian Vladescu and Stefan Strilciuc and Alin Codrut Nicolescu},
journal = {Frontiers in Health Services},
year = {2026},
month = oct,
doi = {10.3389/frhs.2026.1943557},
url = {https://doi.org/10.3389/frhs.2026.1943557},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - On the economic burden of alopecia areata in Romania
AU - Mihaela Olaru
AU - Alin Laurentiu Tatu
AU - Rodica Olteanu
AU - Rozalina Lapadatu
AU - Cristian Vladescu
AU - Stefan Strilciuc
AU - Alin Codrut Nicolescu
PY - 2026
DA - 2026/10/21
JO - Frontiers in Health Services
DO - 10.3389/frhs.2026.1943557
UR - https://doi.org/10.3389/frhs.2026.1943557
AB - Introduction: Alopecia areata (AA) is an immune-mediated disorder that substantially impairs quality of life, social participation, and work productivity while generating considerable healthcare costs. Data regarding its economic burden in Romania are currently lacking. Methods: We conducted a societal-perspective cost-of-illness study for the reference year 2022, combining a cross-sectional online survey of patients and caregivers (41 adult patients and 7 caregiver proxies, of whom 4 reported for pediatric patients) with four national secondary data sources: alopecia areata-specific epidemiological estimates from the Global Burden of Disease (GBD) 2021 study, pharmaceutical market data (IQVIA), hospitalization cost and discharge statistics, and national labor statistics. Survey-derived unit costs were extrapolated to the national level using both prevalence- and incidence-based approaches, combining bottom-up (treatment, medical services, associated expenses), top-down (hospitalizations), and hybrid (productivity losses) costing. Health-related quality of life was assessed with the EQ-5D-5L. Results: The estimated total cost of alopecia areata in Romania in 2022 was EUR 97.95 million for adults and EUR 3.35 million for pediatric patients under the prevalence-based approach, and EUR 170.56 million and EUR 6.37 million, respectively, under the incidence-based approach. In adults, productivity losses (45.2–51.2%) and associated out-of-pocket expenses (28.5–32.2%) were the largest contributors, followed by medical services and treatment. Among pediatric patients, associated expenses, caregiver productivity losses, and treatment were the main cost drivers. Average annual cost per adult patient was EUR 2,608.6, and was higher for mild (EUR 3,248.3) than for severe disease (EUR 1,999.4). Problems with anxiety/depression were the most frequently affected EQ-5D-5L dimension (77.8% of adult respondents; 6 of 7 caregiver proxies). Discussion: This is the first study to estimate the economic burden of alopecia areata in Romania. Although the survey sample was small and self-selected, the combination of patient-reported unit costs with national epidemiological and administrative data allowed national burden estimates under transparent assumptions. The findings highlight the substantial societal cost of alopecia areata — driven primarily by productivity losses and out-of-pocket spending rather than by reimbursed care — and support its consideration in healthcare resource allocation and service planning. Larger, representative studies are warranted to validate these estimates.
SN - 2813-0146
ER -