Atopic dermatitis (AD) has significant psychosocial and financial impact on patients and their families. However, in Burkina Faso, patients have difficulty affording this full range of treatments, even those covered by insurance, as skin moisturizers, for ex- ample, are not reimbursed. This study addresses inequity in the treatment of AD by assessing the direct medical costs borne by patients. We used a study design using records of AD patients from 2019 to 2020 in a public and a private health facility in Oua- gadougou to analyze direct medical costs incurred by patients. A total of 184 patient records were reviewed, 134 in the public facility and 50 in the private. The mean duration of an AD flare-up was 13.9 days. The mean number of AD flare-ups per year was five. The average cost of a consultation was US$4 at the public facility and US$21 at the private facility. Patients with insurance paid an average of 20% of this amount. The average annual direct medical cost of treatment with only drugs, when the patient had no insurance, was US$ 103 in the public health facility and US$ 268 in the private one. When the patient had insurance, this aver- age annual direct medical cost did not vary in the public facility but changed to US$ 134 in the private facility. The average total annual cost of treating AD with both drugs and skin moisturizers in the absence of insurance was US$ 189 in the public health facility and US$ 603 in the private facility. In the presence of insurance, the cost was US$ 468 for patients in the private health facility. The average annual cost of skin moisturizers was US$ 87 in the public health facility and US$ 335 in the private facility. Health insurance did not reimburse skin moisturizers. The costs of AD treatment remain high even for insured patients. Access to treatment is dependent on the purchasing power of patients and this results in inequitable access to care.

atopic dermatitis cost, patient purchassing power