AMCP 2022: Prevalence of Alopecia Areata Is Increasing

Using a claims database, researchers found a steady increase in the prevalence of alopecia areata from 2016 to 2019 among those with employer-based health insurance. They also found a higher prevalence and incidence rate among women than among men.

Research presented at AMCP’s annual meeting suggests that the prevalence of alopecia areata is increasing among those with employer-sponsored health insurance. Markqayne Ray, Pharm.D., MBA, and colleagues used the IBM MarketScan database to identify claims related to alopecia areata, an autoimmune disorder characterized by hair loss. The condition has become well known lately because of Will Smith’s slapping Chris Rock during the Oscars ceremony after Rock made a joke about Smith’s wife’s buzzed hair. Jada Pinkett Smith cut her hair because she has alopecia.

After applying some statistical adjustments, they found that claims submitted suggest that prevalence (the number existing cases) of alopecia areata had crept steadily upward between 2016 and 2019, from 0.199% in 2016 to 0.212% in 2017, to 0.219% in 2018 and to 0.222% in 2019. Their calculations also show prevalence is roughly 60% higher among females (0.252%-0.271%) than among males (0.145%-0.171%) and higher among adults (0.220%-0.245%) than among children (0.120%-0.135%).

Ray and colleagues also calculated the incidence (new cases) by identifying a claim for medical service related to alopecia areata with no diagnosis the year before. The trend in incidence was not as clear as the one in prevalence. According to the research reported at AMCP 2022, the incidence was 91.46 per 100,000 person-years in 2016, 87.39 in 2017, 91.32 in 2018 and 92.9 in 2019. As with prevalence, incidence was quite a bit higher among females than among males (108.53-118.56 vs. 63.68-72.09).

There are three types of alopecia areata: patchy alopecia, which is characterized by, as the name suggests, hair loss in clumps (typically the size of a coin); alopecia totalis, which is characterized by the loss of all or nearly all hair from the scalp; and alopecia universalis, which is characterized by the loss of all or nearly all hair from the face and the rest of the body as well as the scalp. Alopecia totalis and alopecia universalis are far less common than the patchy type.

Ray and colleagues also calculated the prevalence and incidence of alopecia totalis and alopecia universalis. The prevalence rates rose in the same steady way as the overall prevalence of alopecia areata. Consistent with past documentation that alopecia totalis and alopecia universalis are the less common forms of the disease, this research showed that together they account for between 5% and 10% of cases.

Until this year’s Oscars, alopecia was largely unknown to the public, partly because it is relatively rare. But that lack of knowledge jumped to worldwide awareness after Smith slapped Rock; it has been dubbed “the slap heard around the world.” According to several media reports, the comedian has said that he did not know about Pinkett Smith’s medical condition when he made the unscripted joke.

Reviewers of the research submitted for presentation at AMCP 2022 rated Ray and colleagues’ work highly, putting it in the gold category, the second highest after platinum.