The Economic Burden of Alopecia Areata: Evidence from a Survey in Norway and Sweden.

While international studies have assessed the economic burden of alopecia areata (AA), its societal costs have not been quantified in a Nordic context. We conducted a cross-sectional survey among adults with self-reported AA in Norway and Sweden, recruited via a patient organization and social media. A total of 329 respondents (263 from Norway, 66 from Sweden) provided information on demographics, disease characteristics, healthcare utilization, out-of-pocket expenses, productivity losses and treatment satisfaction. Costs were estimated from a societal perspective, combining direct medical, direct non-medical and indirect costs from reduced productivity. The annual mean total cost of AA was €7,677 in Norway and €12,582 in Sweden, with indirect costs (61-64% of the total) as the largest component, primarily driven by presenteeism and long-term sick leave. A notable finding is the significant out-of-pocket costs. In Norway, individuals paid about 65% of direct costs themselves, in Sweden about 50%. Dissatisfaction with treatment and healthcare support was widespread. Only a minority received systemic therapies, and treatment frequency with Janus kinase inhibitors was low, likely due to lack of reimbursement. AA imposes a considerable societal and individual economic burden in Norway and Sweden, underscoring the need for better therapies, healthcare support and policy recognition of its impact.