ARCO and the University of Rome Tor Vergata publish the first Italian study on the societal costs of chronic spontaneous urticaria

The article "The societal costs associated with patients with chronic spontaneous urticaria (CSU) in Italy" has been published in the international scientific journal Global & Regional Health Technology Assessment (GRHTA) (DOI: 10.33393/grhta.2026.3703).

This is the first study conducted in Italy to estimate the indirect costs and out-of-pocket expenses borne by patients with chronic spontaneous urticaria (CSU) — a milestone of significant scientific and social value.

A study born from patients' voices

This work is the result of the invaluable and irreplaceable collaboration of ARCO members and patients — the Association for the Research and Cure of Urticaria — who responded to the survey proposed by the association in spring 2025. Their responses — their daily struggles, their work difficulties, the out-of-pocket expenses quietly borne year after year — have been transformed into internationally recognised scientific data.

The research team

The article was written by ARCO President Elena Radaelli, who participated in patient recruitment and data collection, together with researchers from CEIS-EEHTA at the University of Rome Tor Vergata: Chiara Bini (lead statistician) and Virginia Scansetti, and Andrea Marcellusi from the Department of Pharmaceutical Sciences (DISFARM) at the University of Milan.

Key findings

The study analysed data from 122 patients, 78% of whom had severe disease. Using the human capital approach to estimate indirect costs, the main results are:

• Average annual indirect cost per patient: €4,281, mainly driven by presenteeism (59%) — the reduced work productivity of patients who continue working despite their condition

• Average annual out-of-pocket expenses: €503 per patient, with 63% attributable to private specialist visits and 33% to treatments

• 50% of employed patients lost workdays due to the disease; 63% reported reduced productivity at work

• 45% of patients receive caregiver support; among employed caregivers, 38% lost workdays

• Costs escalate with disease severity: from €812 in mild cases to €5,205 in severe cases

When integrated with prior estimates of NHS direct costs (€1,901/year), indirect costs emerge as the largest component of the overall economic burden of CSU.

Why this study matters

Chronic spontaneous urticaria is a condition whose impact extends far beyond physical symptoms. This study, for the first time in Italy, makes visible the hidden costs that patients face every day: workdays lost, reduced productivity, out-of-pocket specialist visits. Concrete data that can and must inform health policy and improve patient care.

Thank you

A heartfelt thank you goes to every ARCO patient and member who participated in the survey: this article is yours too. Your voice is now scientific literature.

Click here to read the article.