In a recent mixed-methods study, researchers examined the healthcare situation of patients with alopecia areata (AA) in Germany. They combined qualitative interviews with patients and dermatologists and quantitative analysis of nationwide statutory health insurance (SHI) claims data. The research revealed significant barriers to adequate care, most notably the classification of AA as a “lifestyle disease,” resulting in a lack of insurance coverage for treatment. Although over half of patients received at least one drug prescription—mostly topical therapies—access to approved systemic treatments such as Janus kinase inhibitors was very limited. Both patients and dermatologists expressed frustration with the lack of reimbursement, and patients voiced skepticism about side effects and the exclusively symptomatic nature of current therapies. The study also found disparities in care, with urban patients and women more likely to receive treatment than rural residents and men.
The burden of AA on patients in Germany is considerable, driven largely by limited access to effective treatments and insufficient support from the healthcare system. Patients reported a strong desire for more information and opportunities to connect with others facing AA, expressing a range of responses from acceptance to frustration and desperation. Based on these findings, researchers recommend that AA medications be reimbursed by insurance and that an information platform be developed for both patients and healthcare providers.
Reference: Janke TM, Hester B, Müller K, et al. Identifying barriers and disparities in the healthcare of patients with alopecia areata: a mixed-methods analysis using claims data and qualitative interview data. BMJ Open. 2025 May 30;15(5):e098802. doi: 10.1136/bmjopen-2025-098802. PMID: 40447440; PMCID: PMC12128402.
