Papers of the Week

Chronic pruritus has considerable implications for quality of life (QoL). However, its impact on health-related QoL and economic burden is not fully characterized. We administered a cross-sectional survey of 132 patients with chronic pruritus using the Health Utilities Index Mark 3 (HUI3) instrument. Normative data from healthy adults (n=4,187) were obtained from the Joint Canada/U.S. Survey of Health. Quality-adjusted life-year (QALY) loss and economic costs were estimated based on HUI3 scores of chronic pruritus patients vs. controls. Patients with chronic pruritus had lower overall health performance compared to the control (0.56±0.03 vs. 0.86±0.003, p<0.001). In multivariable regression, chronic pruritus was associated with worse overall health performance (coefficient -0.30, 95% CI [-0.33 to -0.27]), most accentuated in the domains of pain (coefficient -0.24, [-0.28 to -0.21]) and emotion (coefficient -0.11, [-0.13 to -0.10]). The reduced HUI3 score correlated to 5.5 average lifetime QALYs lost per patient. Using conservative estimates for willingness-to-pay, the QALY loss translated to an individual lifetime economic burden of $274,921 and a societal burden of $88.8 billion. Chronic pruritus is associated with significant QoL impairment. The economic burden of chronic pruritus highlights the necessity of further research into management options.