Summary
Background
Atopic eczema is an inflammatory skin condition, with a similar impact on health‐related quality of life as other chronic diseases. Increasing pressures on resources within the National Health Service increase the importance of having good economic evidence to inform their allocation.
Objectives
To educate dermatologists about economic methods with reference to currently available economic evidence on eczema.
Methods
The role of different types of economic evidence is illustrated by evidence found in a systematic literature search conducted across 12 online databases up to 22 May 2017. Primary empirical studies either reporting the results of a cost‐of‐illness study or evaluating the cost, utility or full economic evaluation of interventions for preventing or treating eczema were included. Two reviewers independently assessed studies for eligibility and performed data abstraction, with disagreements resolved by a third reviewer. Evidence tables of results were produced for narrative discussion. The reporting quality of economic evaluations was assessed.
Results
Seventy‐eight studies (described in 80 papers) were deemed eligible. Thirty‐three (42%) were judged to be economic evaluations, 12 (15%) cost analyses, six (8%) utility analyses, 26 (33%) cost‐of‐illness studies and one a feasibility study (1%). The calcineurin inhibitors tacrolimus and pimecrolimus, as well as barrier creams, had the most economic evidence available. Partially hydrolysed infant formula was the most commonly evaluated prevention.
Conclusions
The current level of economic evidence for interventions aimed at preventing and treating eczema is limited compared with that available for clinical outcomes, suggesting that greater collaboration between clinicians and economists might be beneficial.
Short abstract
What's already known about this topic?
Resources available for health care are limited and their efficient allocation should be informed by robust economic evidence about value for money.
The scale and quality of economic evidence available for atopic eczema has not previously been examined.
What does this study add?
By comparison with the considerable clinical evidence for interventions to prevent and treat eczema, there is limited economic evidence available.
The economic evidence available is limited in scope with regard to the types and range of interventions evaluated.
The quality of future economic studies could be improved by greater collaboration between economists and clinicians.
https://doi.org/10.1111/bjd.18391 available online
Economic evidence is important, particularly in the current climate of limited healthcare resources. The impact on this within dermatology can be seen, for instance, in the National Health Service (NHS) consultation on reducing prescribing of over‐the‐counter medications in which around a third of medications considered are dermatological in nature.1 To challenge such strategies, if appropriate, and ensure that treatments offering value for money remain available, requires both clinical and economic evidence.
Atopic eczema (atopic dermatitis), herein referred to as eczema, has its highest incidence in the first year of life (13·8 per 100 person‐years; 95% confidence interval 13·7–13·9).2, 3 Eczema is largely managed in primary care, with treatments aiming to control eczema in remission and to manage flare‐ups. Eczema may have a similar impact on health‐related quality of life for patients and families as asthma and diabetes.4, 5 Those with eczema are more likely to develop asthma and allergic rhinitis.6 Given the scale of the condition and its consequences, it is likely to have large cost implications for health systems and families.
Much is already known about the clinical efficacy of interventions for eczema, shown by the scale of evidence included in The Global Resource of Eczema Trials (GREAT) database,7 which, to date, details > 900 systematic reviews and randomized controlled trials. However, it does not include any economic evidence on eczema. It is important to identify, assess and understand the existing economic evidence in order to inform future economic research in this area. This is particularly important given the emergence of biological therapies for moderate‐to‐severe eczema.8, 9
Materials and methods
The review informing this paper was registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42015024633) and the protocol, containing more detailed information on the search strategy and methods used, published.10
Literature search
An electronic search of the following databases was undertaken from their inception dates through to 22 May 2017: MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews of Effects, Cochrane Database of Systematic Reviews, NHS Economic Evaluation Database (stopped adding records March 2015), Econ Lit, Scopus, Health Technology Assessment, Cost‐Effectiveness Analysis Registry and Web of Science.
Studies were eligible for inclusion if they included primary data on cost and/or economic outcomes (utility or willingness to pay) on eczema. There was no restriction on study design, although only full‐text articles published in English were included. Two independent reviewers screened abstracts before accessing the full text of eligible papers to determine inclusion within the review. The references of eligible studies were screened to ensure all relevant literature was identified.
Data extraction
Two reviewers (T.H.S, E.M.) independently extracted data using a data‐extraction form. Reporting quality was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist.11 In this paper, only the quality assessment for full economic evaluations is reported, as many of the items are irrelevant for partial studies. For three publications where T.H.S. was an author,12, 13, 14 the data extraction and quality assessment were completed by N.J.L. and E.M.
Analysis
The narrative synthesis considered the findings in three ways. Firstly, the studies were categorized by type of economic analysis in order to highlight the range of methods used. Secondly, for those studies conducting full economic evaluations the findings in terms of the cost‐effectiveness of the interventions evaluated was considered. In this section studies were categorized into those in which the new intervention was found to be dominant (more effective and less expensive than the comparator), those where a judgement was made about value for money (more costly but also more effective) and those where the new intervention was dominated (more expensive and less effective) by the comparator. The third section considers the reporting quality of studies in order to highlight the importance of critically appraising the available evidence before using it.
Results
The review found that the quantity of economic evidence available is limited. Figure 1 details the results of the literature search. In total, 78 unique studies were detailed within 80 publications (Thomas et al.12 and Thomas et al.13 reported on the same study, as did Garside et al.15 and Pitt et al.16). We included the Health Technology Assessment monograph for each.13, 15 The number of economic studies being published each year is small and relatively static with between three and eight papers published per year since 2002.
Figure 1.
PRISMA flow diagram. NHS, National Health Service; EED, Economic Evaluation Database; CEA, Cost‐Effectiveness Analysis; AE, atopic eczema.
The variety of interventions considered were relatively limited when compared with the 240 intervention groups listed on the GREAT database. Of the studies found within this review, the most commonly evaluated intervention types were topical calcineurin inhibitors (n = 14),15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28 followed by infant formula feeds intended to prevent eczema from developing (n = 10).29, 30, 31, 32, 33, 34, 35, 36, 37, 38 Six studies evaluated a change of service delivery, including the use of web‐based consultations,39 delivering care by a nurse practitioner,40, 41, 42 the development of a paediatric dermatology service (although what this entailed was not described)43 and the use of interdisciplinary group sessions with an educational counterpart.44 Mason et al. also evaluated an educational support programme, which included the provision of an educational DVD and telephone support.45 Moisturizers or barrier creams were evaluated in six studies.46, 47, 48, 49, 50, 51 Other preparations evaluated included fluticasone propionate ointment;52 topical prednicarbate;53 and some oral preparations, including montelukast,54 bacterial lysate,55 ciclosporin A56 and antibiotics (vs. an antibiotic cream) for infected eczema.57 Homeopathic interventions were evaluated in three studies.58, 59, 60 One study examined the use of ion‐exchange water softeners for the treatment of eczema in children.14 One study, discussed in two publications,12, 13 evaluated the use of silk clothing by children with moderate‐to‐severe eczema.
Economic methods used by studies
This section describes the type of methods used in the papers found. Different methods can inform different types of questions. Fewer than half of the studies undertook full economic evaluations – those studies comparing as in comparing both costs and outcomes for two or more interventions, (cost–benefit, cost–utility or cost‐effectiveness analyses). The remainder looked only at partial economic aspects, including costs, outcomes or cost‐of‐illness studies. These studies alone cannot inform decisions about the efficient allocation of resources, as they do not provide relative estimates of costs and effects of alternative provisions. They do still have value as a source of evidence that can inform the design of future studies or provide evidence to inform parameters for economic models, for instance.
Partial economic studies
Outcome‐only studies
Six studies that just considered outcomes were identified.57, 61, 62, 63, 64, 65 These studies may help to inform the design of future economic evaluations or to parameterize economic models. Two papers conducted a willingness‐to‐pay study in Germans with eczema.61, 62 Both studies found that patients would be willing to spend in the range of €50 (for controlled eczema) to €150 (for uncontrolled eczema) per month to achieve a complete cure.
Stevens et al. developed a disease‐specific preference‐based health measure, Atopic Dermatitis Quality of Life (ADQoL), for economic evaluation of children with eczema.65 Parental interviews generated items that formed 16 unique health states, which were then valued using standard gamble methods, which presents respondents with two alternatives, one a certain outcome in some suboptimal health state, and the other a probability of being in perfect health or immediately dead. The probability is varied until the respondent is indifferent between the two alternatives. Mean ± SD estimates for the 16 health states ranged from 0·36 ± 0·36 for the worst state to 0·84 ± 0·19 for the best health state. ADQoL has been used in few trial evaluations, although the estimates in the paper have been more widely used in economic modelling studies. Only three trial‐based full‐ or feasibility‐stage economic evaluations in this review used the ADQoL descriptive system to elicit a health state description for each participant.13, 50, 57 Francis et al. tested the construct and face validity of the ADQoL completed by parents of children with eczema vs. the clinical measures Patient Oriented Eczema Measure (POEM), Eczema Area and Severity Index (EASI) and Infants’ Dermatitis Quality of Life Index (IDQoL).57, 65 This study supported the use of ADQoL but noted that parents of the youngest participants found it harder to complete. Only two studies considered outcome studies in a paediatric population.57, 65 As eczema often starts in childhood there is a need to have measures of utility that are suitable and validated in the very young.
Cost studies
The majority of cost analyses were performed alongside clinical trials, where costs were not combined with outcome data,17, 19, 39, 41, 44, 45, 54, 58 and some had weaknesses in their methodological approach. For example, Staab et al. looked at the treatment costs of participants but failed to cost the intervention that was being evaluated.44 Furthermore, Bergmo et al. only reported the cost of baseline resource use, not the cost of any subsequent resource use.39 Kernick et al. were also limited in the costs disclosed, stating only a few costs associated with the intervention.41 While Boguniewicz et al. did perform a cost analysis, the study focused more so on the development of a framework for assessing outcomes, intended to inform future research.17 Four studies completed retrospective cost analyses using administrative databases,21, 22, 43, 60 and one feasibility study identified potential cost drivers for a future trial.50
Only one study explored the potential methodological challenges in costing eczema interventions and care. Mason et al. compared methods used to estimate emollient resource use, contrasting daily diary recording of emollient use to estimates of time taken to use a 500‐g container of emollient.45 However, the method chosen was found to have only a small effect on the estimated cost. See Table S1 (see Supporting Information) for further details of these studies.
Cost of illness
Cost‐of‐illness studies estimate the financial burden of a condition for a defined population.66 These studies show decision‐makers the size of the problem relative to other conditions so can help inform the planning of services and care. Such studies vary in how different costs are captured and the complexity of methods used.67 A total of 26 studies (33%) were considered to have conducted a form of cost‐of‐illness study,68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93 one of which used a model developed in Excel (Microsoft, Redmond, WA, U.S.A.).68 Most of these studies evaluated the cost of eczema within children,68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79 with only two papers stating explicitly that they were evaluating adults with eczema.80, 81 Other papers did not specify the population age, with 11 stating a population of patients with eczema.82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92 Filanovsky et al. studied the carers of children with eczema.93
Seven studies compared the eczema cohort to other groups, mainly those without eczema or allergic disease,69, 70, 83, 84, 85 to calculate an incremental cost of treatment.94 One study compared patients with eczema to those with diabetes.79 Table S2 (see Supporting Information) provides further details of these studies.
The most recent cost‐of‐illness figures published in the U.K. were by Herd et al. in 1996,92 based on self‐reported data from a sample of 155 people with eczema. These old estimates require updating, with analysis using real‐world observational data and methods to better inform current policies for eczema in the U.K.
Feasibility study
One feasibility randomized controlled trial was found,50 which included an economic evaluation component and looked at four different leave‐on emollients in those aged < 5 years. Such studies are primarily undertaken to help inform design decisions for full trials, including to identify appropriate outcomes, items of resource use to collect and the completeness of this data by data‐collection methods.
Full economic evaluations
Full economic evaluations accounted for 42% of the unique studies found. Of these, 24 were model‐based economic evaluations. Ten studies were conducted alongside a trial and were from the U.K. (three studies, one reported in two papers) and multiple sites in Europe (n = 2), the Netherlands (n = 2), Finland (n = 1), Germany (n = 1) and the U.S.A. (n = 1).12, 13, 14, 18, 20, 40, 42, 46, 52, 56, 59
Cost–benefit studies
Cost–benefit analyses are the broadest type of economic evaluation, as they seek to value the consequences of an intervention in monetary terms to enable comparisons between interventions across, as well as within, sectors of the economy. No studies detailing cost–benefit analyses were found.
Cost–utility analyses
Cost–utility analyses measure the consequences of an intervention in terms of healthy years, which are typically measured as quality‐adjusted life‐years. This is the most commonly used method to inform resource‐allocation decisions within the NHS, as advocated in the National Institute for Health and Care Excellence reference case.95 The generic outcome measure enables comparisons to be made across disease areas. Only four cost–utility analyses that were not model based were found in the review,12, 13, 14, 18, 20 one of which was described in two papers.12, 13 The method of generating utilities in these studies varied. Poole et al.18 used answers from the Short Form (SF) 12 (SF‐12), and then a mapping algorithm to predict EuroQoL‐5D (EQ‐5D) responses,96 from which the U.K. tariff was used to generate utility values. In comparison, Wollenberg et al. also used SF‐36 responses but used a mapping algorithm developed by Brazier et al.20, 97 Thomas et al.14 used the youth version of the EQ‐5D (EQ‐5D‐Y) for children aged > 3 years, generating utility values using the U.K. tariff derived from an adult population (acknowledged as a potential weakness in the study). Only one study, as described in Thomas et al.,12, 13 used the ADQoL.
Cost‐effectiveness analyses
Cost‐effectiveness analyses value the consequences on an intervention in terms of natural units (e.g. the number of eczema flares prevented). Cost‐effectiveness analyses are mainly designed to inform resource‐allocation decisions within the same condition. Six studies conducted a cost‐effectiveness analysis.40, 42, 46, 52, 56, 59 The majority of these focused on clinical outcomes, including the percentage improvement in EASI score;46 number of remission days per patient;56 number of successfully treated flares;52 and eczema severity assessed using SCORing Atopic Dermatitis (SCORAD).59 By contrast, two studies considered a health‐related quality‐of‐life measure, with Schuttelaar et al. using the IDQoL for children aged < 4 years and the Children's Dermatology Life Quality Index for children aged 4–16 years.40 van Os‐Medendorp et al. used the IDQoL for children and the Dermatology Life Quality Index for adults.42
Modelling studies
Twenty‐four papers used a model to evaluate a prevention or intervention for eczema,15, 16, 24, 25, 26, 27, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 47, 48, 49, 51, 53, 55, 98, 99 11 of which used cost–utility analyses, nine cost‐effectiveness analyses, three both cost–utility analyses and cost‐effectiveness analyses, and one both cost minimization analysis and cost‐effectiveness analyses. The economic methods used in these studies and their quality are examined elsewhere and so will not be discussed further.100
Cost‐effectiveness results for interventions to prevent and treat eczema
Ten studies (described in 11 papers) undertook full economic evaluations.12, 13, 14, 18, 20, 40, 42, 46, 52, 56, 59 Interventions estimated to be dominant (more effective and less expensive) included tacrolimus ointment;20 ciclosporin;56 care by a nurse practitioner;40 and care package with access to an electronic eczema portal.42 Two interventions were judged to be cost‐effective (i.e. they had higher costs that were justified by greater effectiveness given societies willingness to pay for health gain): fluticasone propionate (twice‐daily application)52 and tacrolimus ointment.18 Silk clothing, along with standard care,13 ion‐exchange water softener,14 homeopathy,59 Atopiclair and EpiCeram,46 were dominated (cost more and were less effective than their comparators). It should be noted that such statements lack usefulness without knowing the perspective, time frame, precise detail of the comparator, country of study, etc., for each study. That different economic evaluations of the same intervention can reach different conclusions is illustrated here by tacrolimus ointment. In the study that required a judgement to be made about cost‐effectiveness,18 tacrolimus ointment was compared with hydrocortisone ointment, whereas the economic evaluation finding tacrolimus ointment to be dominant was comparing it with usual care.20 Therefore, we provide fuller details in Table S3 (see Supporting Information) to aid interpretation of the results.
It is clear from Table S3 that the range of interventions evaluated fully is limited. This inevitably limits the ability of decision‐makers to use such evidence to inform their resource‐allocation decisions about how to allocate resources. This affects not only allocation to different eczema interventions, but also between eczema and other disease areas. The best resource‐allocation decisions are likely to be made where an array of evidence exists, which can be integrated to inform an economic model. Economic decision models often facilitate this, but in the area of eczema these models tend to be of insufficient time frame and quality.100 The evidence in Table S3 suggests that current decisions are likely to be made either on the basis of no evidence (where none exists) or based on a single influential trial. The CLOTHES trial,13 for example, seems to provide the sole evidence justifying guidance suggesting silk garments should not be routinely prescribed in any circumstance in NHS primary care.101 In the absence of good economic evidence, good decisions will not be made about resource allocation in eczema.
Reporting quality of the economic evidence available
The reporting quality of the full economic evaluations was assessed using the CHEERS checklist,11 detailed in Table S4 (see Supporting Information). This checklist was developed as part of an initiative to consolidate and update existing health economic checklists into one checklist. No study met all the CHEERS criteria, with the percentage of applicable items fulfilled ranging from 42% (Green et al.)52 to 95% (Thomas et al.).14 The checklist items least often met were checklist items 6 (‘Study perspective’), 20a (‘Characterising uncertainty’) and 21 (‘Characterising heterogeneity’). Study perspective is the viewpoint taken in the analysis (e.g. from the point of view of the patient, NHS institution or of society), which is important as the cost‐effectiveness of an intervention may depend on which viewpoint is taken. Four of the 11 full economic evaluations did not explicitly state the perspective being used within their analysis requiring the reader to make inferences based on the resource use/costs and outcomes reported.18, 46, 52, 56 By not stating the perspective of the evaluation, it was difficult to assess whether all of the appropriate resource use and costs had been included. Eight of the studies did not conduct subgroup analyses to examine how observable characteristics of the patients might influence results (referred to as characterizing heterogeneity), this may have been appropriate, but justification for this omission was not provided in the papers.13, 14, 18, 42, 46, 52, 56, 59 Moreover, five of the 11 full economic evaluations did not report a price year.18, 20, 46, 52, 59 In order to compare different cost‐effectiveness estimates, often you need to inflate them to a common price year, which without knowing the original price year is difficult to do. The majority of full economic evaluations clearly reported the source of funding for the study (with the exception of Green et al.)52 and conflicts of interest (with the exception of Green et al., Miller et al. and Witt et al.).46, 52, 59
Discussion
This study has used results from a systematic review to demonstrate the type and quality of economic research currently available to support evidence‐based decisions for eczema. It appears insufficient to inform decision‐makers about how to allocate limited resources between eczema and other disease areas, nor how best to use resources allocated to eczema to maximize health outcomes. The current evidence base surrounding the economics of eczema has gaps, which, if filled, could help to inform future research efforts in this area.
It was encouraging to find that economic evaluations were the most commonly found study type. The majority used decision modelling. The low number of economic evaluations conducted alongside randomized controlled trials was surprising given the number of clinical trials that have been conducted for eczema.7 Those undertaking trials may not be aware of the importance of incorporating economic outcomes within their study or may lack skills in this area. Cost‐of‐illness studies were the second most common type found, covering a range of countries and methods. They demonstrated the range of costs incurred by healthcare systems, families and society as a result of eczema. However, the U.K.‐relevant estimates are out of date.92 It is important that future cost‐of‐illness studies must have good methodology, including a control group to obtain realistic estimates.
The range of interventions with economic evidence available is also limited. The majority of studies were conducted over short time horizons and so indicate little about the long‐term value for money of the interventions. Clinicians and economists might be able to improve this by working together to identify where important economic questions exist. The new high‐cost treatments for eczema, such as biologics,102 must be evaluated appropriately and for a sufficient duration.
As eczema often starts at a young age, measures of utility must be suitable and validated in the very young. Similar to other disease areas in children, further economic research is needed.103 The Harmonising Outcome Measures for Eczema initiative has so far been unable to reach consensus on a single quality‐of‐life measure to be included in the core outcome set.104, 105 No single instrument has been well tested, which exacerbates problems in eczema health economic assessments.
To our knowledge, this is the first collation of all types of economic evidence on the topic of eczema. It is informative in identifying interventions, populations and methodological gaps where further research is needed. However, there are limitations, particularly that the search only covered published research and therefore may have missed guidance documents relevant to the economic evidence of eczema. The data extraction was dependent on the subjective view of those extracting the information and, at points, it was difficult to classify some studies, particularly those that performed partial cost analyses. While the inclusion criteria only included English‐language articles, the search was not restricted by publication language and, consequently, 12 foreign‐language papers were identified that, based on the English abstract and title, appeared potentially relevant.106, 107, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117 We reference them here in case they are of use to multilingual researchers. We also recognize that since the search was undertaken, further relevant economic studies have been published.118, 119, 120, 121, 122, 123, 124, 125, 126 However, our primary aim was to use the available literature to increase understanding about the range of economic methods available as with understanding may come more appropriate use of these methods.
At a time where access to public health services is being more overtly restricted, economic evidence is important to help inform that process and ensure transparent justification. This study has found a paucity of economic evidence for interventions aimed at preventing and treating eczema, suggesting the need for clinicians to incorporate health economics within their study design more frequently. The evidence that is available is of variable quality such that not only is there a need for more research, but also for more methodologically robust research.
Supporting information
Table S1 Characteristics of the cost analyses, outcome studies and feasibility study.
Table S2 Cost‐of‐illness study characteristics.
Table S3 Overview of the economic evaluations of interventions for eczema.
Table S4 Reporting quality assessment of the full economic evaluations according to the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist.
Video S1 Author video.
Acknowledgments
The following individuals are acknowledged as providing advice as research mentors (Professor Kim Thomas and Professor Nicky Welton) and as part of the annual advisory panel (Dr Tom Kenny, Professor Nick Levell, Fiona McOwan, Jo Parris, Amanda Roberts, Professor Lee Shepstone, Professor Fujian Song and Dr Edward Wilson), and for contributing to data extraction (Miss Amy Dymond) and the search strategy and data extraction (Mr Christopher McMonagle).
Funding sources This systematic review is independent research arising from T.S's Career Development Fellowship (CDF‐2014‐07‐006) supported by the National Institute for Health Research (NIHR). The views expressed in this publication are those of the author(s) and not necessarily those of the National Health Service, the NIHR, or the Department of Health and Social Care.
Conflicts of interest N.J.L. is a trustee and an officer of the British Association of Dermatologists, which owns the British Journal of Dermatology. T.H.S. is an author on several of the papers included in the review, but these were assessed by other members of the research team.
https://doi.org/10.1111/bjd.18391 available online
References
- 1. NHS England . Conditions for which over the counter items should not routinely be prescribed in primary care: a consultation on guidance for CCGs. Available at: https://www.england.nhs.uk/medicines/conditions-for-which-over-the-counter-items-should-not-routinely-be-prescribed/ (last accessed 12 March 2019).
- 2. Williams HC. Atopic eczema. BMJ 1995; 311:1241. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3. Ban L, Langan SM, Abuabara K et al Incidence and sociodemographic characteristics of eczema diagnosis in children: a cohort study. J Allergy Clin Immunol 2018; 141:1927–9. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4. Paller AS, Mcalister RO, Doyle JJ et al Perceptions of physicians and pediatric patients about atopic dermatitis, its impact, and its treatment. Clin Pediatr 2002; 41:323–32. [DOI] [PubMed] [Google Scholar]
- 5. Lewis‐Jones S. Quality of life and childhood atopic dermatitis: the misery of living with childhood eczema. Int J Clin Pract 2006; 60:984–92. [DOI] [PubMed] [Google Scholar]
- 6. Hon KLE, Wang SS, Leung T‐F. The atopic march: from skin to the airways. Iran J Allergy Asthma Immunol 2012; 11:73. [PubMed] [Google Scholar]
- 7. Nankervis H, Maplethorpe A, Williams HC. Mapping randomized controlled trials of treatments for eczema – the GREAT database (The Global Resource of Eczema Trials: a collection of key data on randomized controlled trials of treatments for eczema from 2000 to 2010). BMC Dermatol 2011; 11:10. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 8. Simpson EL, Chalmers JR, Hanifin JM et al Emollient enhancement of the skin barrier from birth offers effective atopic dermatitis prevention. J Allergy Clin Immunol 2014; 134:818–23. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 9. Beck LA, Thaçi D, Hamilton JD et al Dupilumab treatment in adults with moderate‐to‐severe atopic dermatitis. N Engl J Med 2014; 371:130–9. [DOI] [PubMed] [Google Scholar]
- 10. Sach TH, McManus E, McMonagle C et al Economic evidence for the prevention and treatment of atopic eczema: a protocol for a systematic review. Syst Rev 2016; 5:90. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 11. Husereau D, Drummond M, Petrou S et al Consolidated health economic evaluation reporting standards (CHEERS) statement. BMJ 2013; 11:6. [DOI] [PubMed] [Google Scholar]
- 12. Thomas KS, Bradshaw LE, Sach TH et al Silk garments plus standard care compared with standard care for treating eczema in children: a randomised, controlled, observer‐blind, pragmatic trial (CLOTHES Trial). PLOS Med 2017; 14:e1002280. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 13. Thomas KS, Bradshaw LE, Sach TH et al Randomised controlled trial of silk therapeutic garments for the management of atopic eczema in children: the CLOTHES trial. Health Technol Assess 2017; 21:1–260. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 14. Thomas KS, Koller K, Dean T et al A multicentre randomised controlled trial and economic evaluation of ion‐exchange water softeners for the treatment of eczema in children: the Softened Water Eczema Trial (SWET). Health Technol Assess 2011; 15:1–156. [DOI] [PubMed] [Google Scholar]
- 15. Garside R, Stein K, Castelnuovo E et al The effectiveness and cost‐effectiveness of pimecrolimus and tacrolimus for atopic eczema: a systematic review and economic evaluation. Health Technol Assess 2005; 9:1–230. [DOI] [PubMed] [Google Scholar]
- 16. Pitt M, Garside R, Stein K. A cost‐utility analysis of pimecrolimus vs. topical corticosteroids and emollients for the treatment of mild and moderate atopic eczema. Br J Dermatol 2006; 154:1137–46. [DOI] [PubMed] [Google Scholar]
- 17. Boguniewicz M, Abramovits W, Paller A et al A multiple‐domain framework of clinical, economic, and patient‐reported outcomes for evaluating benefits of intervention in atopic dermatitis. J Drugs Dermatol 2007; 6:416–23. [PubMed] [Google Scholar]
- 18. Poole CD, Chambers C, Allsopp R et al Quality of life and health‐related utility analysis of adults with moderate and severe atopic dermatitis treated with tacrolimus ointment vs. topical corticosteroids. J Eur Acad Dermatol Venereol 2010; 24:674–8. [DOI] [PubMed] [Google Scholar]
- 19. Thaci D, Chambers C, Sidhu M et al Twice‐weekly treatment with tacrolimus 0.03% ointment in children with atopic dermatitis: clinical efficacy and economic impact over 12 months. J Eur Acad Dermatol Venereol 2010; 24:1040–6. [DOI] [PubMed] [Google Scholar]
- 20. Wollenberg A, Sidhu MK, Odeyemi I et al Economic evaluation of maintenance treatment with tacrolimus 0.1% ointment in adults with moderate to severe atopic dermatitis. Br J Dermatol 2008; 159:1322–30. [DOI] [PubMed] [Google Scholar]
- 21. Chang J, Sung J. Health plan budget impact analysis for pimecrolimus. J Manag Care Pharm 2005; 11:66–73. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 22. Delea TE, Gokhale M, Makin C et al Administrative claims analysis of utilization and costs of care in health plan members with atopic dermatitis who had prior use of a topical corticosteroid and who initiate therapy with pimecrolimus or tacrolimus. J Manag Care Pharm 2007; 13:349–59. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 23. Abramovits W, Boguniewicz M, Paller AS et al The economics of topical immunomodulators for the treatment of atopic dermatitis. Pharmacoeconomics 2005; 23:543–66. [DOI] [PubMed] [Google Scholar]
- 24. Coyle D, Barbeau M. Cost effectiveness of Elidel in the management of patients with atopic dermatitis in Canada. J Cutan Med Surg 2004; 8:405–10. [DOI] [PubMed] [Google Scholar]
- 25. Ellis CN, Drake LA, Prendergast MM et al Cost‐effectiveness analysis of tacrolimus ointment versus high‐potency topical corticosteroids in adults with moderate to severe atopic dermatitis. J Am Acad Dermatol 2003; 48:553–63. [DOI] [PubMed] [Google Scholar]
- 26. Ellis CN, Kahler KH, Grueger J et al Cost effectiveness of management of mild‐to‐moderate atopic dermatitis with 1% pimecrolimus cream in children and adolescents 2–17 years of age. Am J Clin Dermatol 2006; 7:133–9. [DOI] [PubMed] [Google Scholar]
- 27. Healy E, Bentley A, Fidler C et al Cost‐effectiveness of tacrolimus ointment in adults and children with moderate and severe atopic dermatitis: twice‐weekly maintenance treatment vs. standard twice‐daily reactive treatment of exacerbations from a third party payer (U.K. National Health Service) perspective. Br J Dermatol 2011; 164:387–95. [DOI] [PubMed] [Google Scholar]
- 28. Hjelmgren J, Svensson A, Jorgensen ET et al Cost‐effectiveness of tacrolimus ointment vs. standard treatment in patients with moderate and severe atopic dermatitis: a health‐economic model simulation based on a patient survey and clinical trial data. Br J Dermatol 2007; 156:913–21. [DOI] [PubMed] [Google Scholar]
- 29. Mertens J, Stock S, Lungen M et al Is prevention of atopic eczema with hydrolyzed formulas cost‐effective? A health economic evaluation from Germany. Pediatr Allergy Immunol 2012; 23:597–604. [DOI] [PubMed] [Google Scholar]
- 30. Su J, Prescott S, Sinn J et al Cost‐effectiveness of partially‐hydrolyzed formula for prevention of atopic dermatitis in Australia. J Med Econ 2012; 15:1064–77. [DOI] [PubMed] [Google Scholar]
- 31. Bhanegaonkar A, Horodniceanu EG, Ji X et al Economic burden of atopic dermatitis in high‐risk infants receiving cow's milk or partially hydrolyzed 100% whey‐based formula. J Pediatr 2015; 166:1145–51.e3. [DOI] [PubMed] [Google Scholar]
- 32. Bhanegaonkar AJ, Horodniceanu EG, Abdul Latiff AH et al Economic value of atopic dermatitis prevention via infant formula use in high‐risk Malaysian infants. Asia Pac Allergy 2015; 5:84–97. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 33. Bhanegaonkar AJ, Horodniceanu EG, Gonzalez RRH et al Cost‐effectiveness of partially hydrolyzed whey protein formula in the primary prevention of atopic dermatitis in at‐risk urban Filipino infants. Value Health Reg Issues 2014; 3:124–35. [DOI] [PubMed] [Google Scholar]
- 34. Botteman M, Detzel P. Cost‐effectiveness of partially hydrolyzed whey protein formula in the primary prevention of atopic dermatitis in high‐risk urban infants in Southeast Asia. Ann Nutr Metab 2015; 66:26–32. [DOI] [PubMed] [Google Scholar]
- 35. Iskedjian M, Belli D, Farah B et al Economic evaluation of a 100% whey‐based partially hydrolyzed infant formula in the prevention of atopic dermatitis among Swiss children. J Med Econ 2012; 15:378–93. [DOI] [PubMed] [Google Scholar]
- 36. Iskedjian M, Dupont C, Spieldenner J et al Economic evaluation of a 100% whey‐based, partially hydrolysed formula in the prevention of atopic dermatitis among French children. Curr Med Res Opin 2010; 26:2607–26. [DOI] [PubMed] [Google Scholar]
- 37. Iskedjian M, Haschke F, Farah B et al Economic evaluation of a 100% whey‐based partially hydrolyzed infant formula in the prevention of atopic dermatitis among Danish children. J Med Econ 2012; 15:394–408. [DOI] [PubMed] [Google Scholar]
- 38. Lenoir‐Wijnkoop I, van Aalderen WM, Boehm G et al Cost‐effectiveness model for a specific mixture of prebiotics in The Netherlands. Eur J Health Econ 2012; 13:101–10. [DOI] [PubMed] [Google Scholar]
- 39. Bergmo TS, Wangberg SC, Schopf TR et al Web‐based consultations for parents of children with atopic dermatitis: results of a randomized controlled trial. Acta Paediatr 2009; 98:316–20. [DOI] [PubMed] [Google Scholar]
- 40. Schuttelaar ML, Vermeulen KM, Coenraads PJ. Costs and cost‐effectiveness analysis of treatment in children with eczema by nurse practitioner vs. dermatologist: results of a randomized, controlled trial and a review of international costs. Br J Dermatol 2011; 165:600–11. [DOI] [PubMed] [Google Scholar]
- 41. Kernick D, Cox A, Powell R et al A cost consequence study of the impact of a dermatology‐trained practice nurse on the quality of life of primary care patients with eczema and psoriasis. Br J Gen Pract 2000; 50:555–8. [PMC free article] [PubMed] [Google Scholar]
- 42. van Os‐Medendorp H, Koffijberg H, Eland‐de Kok PC et al E‐health in caring for patients with atopic dermatitis: a randomized controlled cost‐effectiveness study of internet‐guided monitoring and online self‐management training. Br J Dermatol 2012; 166:1060–8. [DOI] [PubMed] [Google Scholar]
- 43. Beal BT, Prodanovic E, Kuo JE et al Impact of a pediatric dermatology service on emergency department utilization for children with dermatitis. Pediatr Dermatol 2016; 33:69–74. [DOI] [PubMed] [Google Scholar]
- 44. Staab D, von Rueden U, Kehrt R et al Evaluation of a parental training program for the management of childhood atopic dermatitis. Pediatr Allergy Immunol 2002; 13:84–90. [DOI] [PubMed] [Google Scholar]
- 45. Mason JM, Carr J, Buckley C et al Improved emollient use reduces atopic eczema symptoms and is cost neutral in infants: before‐and‐after evaluation of a multifaceted educational support programme. BMC Dermatol 2013; 13:7. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 46. Miller DW, Koch SB, Yentzer BA et al An over‐the‐counter moisturizer is as clinically effective as, and more cost‐effective than, prescription barrier creams in the treatment of children with mild‐to‐moderate atopic dermatitis: a randomized, controlled trial. J Drugs Dermatol 2011; 10:531–7. [PubMed] [Google Scholar]
- 47. Hjalte F, Asseburg C, Tennvall GR. Cost‐effectiveness of a barrier‐strengthening moisturizing cream as maintenance therapy vs. no treatment after an initial steroid course in patients with atopic dermatitis in Sweden – with model applications for Denmark, Norway and Finland. J Eur Acad Dermatol Venereol 2010; 24:474–80. [DOI] [PubMed] [Google Scholar]
- 48. Tang MB, Leong KF, Ou LS et al Cost‐effectiveness study of pediatric atopic dermatitis in Asia: atopiclair vs. regular emollient (AD‐ATOP). J Drugs Dermatol 2015; 14:169–75. [PubMed] [Google Scholar]
- 49. Norrlid H, Hjalte F, Lundqvist A et al Cost‐effectiveness of maintenance treatment with a barrier‐strengthening moisturizing cream in patients with atopic dermatitis in Finland, Norway and Sweden. Acta Dermatovenereol 2016; 96:173–6. [DOI] [PubMed] [Google Scholar]
- 50. Ridd MJ, Garfield K, Gaunt DM et al Choice of Moisturiser for Eczema Treatment (COMET): feasibility study of a randomised controlled parallel group trial in children recruited from primary care. BMJ Open 2016; 6:e012021. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 51. Xu S, Immaneni S, Hazen GB et al Cost‐effectiveness of prophylactic moisturization for atopic dermatitis. JAMA Pediatr 2017; 171:e163909. [DOI] [PubMed] [Google Scholar]
- 52. Green C, Colquitt JL, Kirby J et al Topical corticosteroids for atopic eczema: clinical and cost effectiveness of once‐daily vs. more frequent use. Br J Dermatol 2005; 152:130–41. [DOI] [PubMed] [Google Scholar]
- 53. de Tiedra A, Mercadal J, Lozano R. Prednicarbate versus fluocortin for inflammatory dermatoses. A cost‐effectiveness study. Pharmacoeconomics 1997; 12:193–208. [DOI] [PubMed] [Google Scholar]
- 54. Ehlayel MS, Bener A. Does montelukast reduce the treatment cost in children with moderately severe atopic dermatitis. Curr Pediatr Res 2008; 12:1–4. [Google Scholar]
- 55. Kiencke P, Viehmann K, Rychlik R. Cost‐effectiveness analysis, prevention of atopic dermatitis by oral application of bacterial lysate in newborns/small children. Eur J Health Econ 2013; 14:995–1002. [DOI] [PubMed] [Google Scholar]
- 56. Salo H, Pekurinen M, Granlund H et al An economic evaluation of intermittent cyclosporin A therapy versus UVAB phototherapy in the treatment of patients with severe atopic dermatitis. Acta Dermatovenereol 2004; 84:138–41. [DOI] [PubMed] [Google Scholar]
- 57. Francis NA, Ridd MJ, Thomas‐Jones E et al A randomised placebo‐controlled trial of oral and topical antibiotics for children with clinically infected eczema in the community: the ChildRen with Eczema, Antibiotic Management (CREAM) study. Health Technol Assess 2016; 20:1–84. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 58. Roll S, Reinhold T, Pach D et al Comparative effectiveness of homoeopathic vs. conventional therapy in usual care of atopic eczema in children: long‐term medical and economic outcomes. PLOS ONE 2013; 8:e54973. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 59. Witt CM, Brinkhaus B, Pach D et al Homoeopathic versus conventional therapy for atopic eczema in children: medical and economic results. Dermatology 2009; 219:329–40. [DOI] [PubMed] [Google Scholar]
- 60. Ostermann JK, Reinhold T, Witt CM. Can additional homeopathic treatment save costs? A retrospective cost‐analysis based on 44500 insured persons. PLOS ONE 2015; 10:e0134657. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 61. Beikert FC, Langenbruch AK, Radtke MA et al Willingness to pay and quality of life in patients with atopic dermatitis. Arch Dermatol Res 2014; 306:279–86. [DOI] [PubMed] [Google Scholar]
- 62. Schmitt J, Meurer M, Klon M et al Assessment of health state utilities of controlled and uncontrolled psoriasis and atopic eczema: a population‐based study. Br J Dermatol 2008; 158:351–9. [DOI] [PubMed] [Google Scholar]
- 63. Simpson EL, Bieber T, Eckert L et al Patient burden of moderate to severe atopic dermatitis (AD): insights from a phase 2b clinical trial of dupilumab in adults. J Am Acad Dermatol 2016; 74:491–8. [DOI] [PubMed] [Google Scholar]
- 64. Vinding GR, Knudsen KM, Ellervik C et al Self‐reported skin morbidities and health‐related quality of life: a population‐based nested case‐control study. Dermatology 2014; 228:261–8. [DOI] [PubMed] [Google Scholar]
- 65. Stevens K, Brazier J, McKenna S et al The development of a preference‐based measure of health in children with atopic dermatitis. Br J Dermatol 2005; 153:372–7. [DOI] [PubMed] [Google Scholar]
- 66. Drummond MF, Sculpher MJ, Claxton K et al Methods for the Economic Evaluation of Health Care Programmes. Oxford: Oxford University Press, 2015. [Google Scholar]
- 67. Akobundu E, Ju J, Blatt L et al Cost‐of‐illness studies. Pharmacoeconomics 2006; 24:869–90. [DOI] [PubMed] [Google Scholar]
- 68. Ngamphaiboon J, Kongnakorn T, Detzel P et al Direct medical costs associated with atopic diseases among young children in Thailand. J Med Econ 2012; 15:1025–35. [DOI] [PubMed] [Google Scholar]
- 69. Alanne S, Maskunitty A, Nermes M et al Costs of allergic diseases from birth to two years in Finland. Public Health 2012; 126:866–72. [DOI] [PubMed] [Google Scholar]
- 70. Hammer‐Helmich L, Linneberg A, Thomsen SF et al Health service use among children with and without eczema, asthma, and hay fever. Clin Epidemiol 2016; 8:341–9. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 71. Emerson RM, Williams HC, Allen BR. What is the cost of atopic dermatitis in preschool children? Br J Dermatol 2001; 144:514–22. [DOI] [PubMed] [Google Scholar]
- 72. Handa S, Jain N, Narang T. Cost of care of atopic dermatitis in India. Indian J Dermatol 2015; 60:213. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 73. Lapidus CS, Schwarz DF, Honig PJ. Atopic dermatitis in children: who cares? Who pays? J Am Acad Dermatol 1993; 28:699–703. [DOI] [PubMed] [Google Scholar]
- 74. Misery L, Ansolabehere X, Grandfils N et al Nine‐year follow‐up of children with atopic dermatitis by general practitioners. Dermatology 2014; 228:344–9. [DOI] [PubMed] [Google Scholar]
- 75. Ricci G, Bendandi B, Pagliara L et al Atopic dermatitis in Italian children: evaluation of its economic impact. J Pediatr Health Care 2006; 20:311–15. [DOI] [PubMed] [Google Scholar]
- 76. Weinmann S, Kamtsiuris P, Henke KD et al The costs of atopy and asthma in children: assessment of direct costs and their determinants in a birth cohort. Pediatr Allergy Immunol 2003; 14:18–26. [DOI] [PubMed] [Google Scholar]
- 77. Arnold RJ, Donnelly A, Altieri L et al Assessment of outcomes and parental effect on quality‐of‐life endpoints in the management of atopic dermatitis. Manag Care Interface 2007; 20:18–23. [PubMed] [Google Scholar]
- 78. Hughes R, Ward D, Tobin AM et al The use of alternative medicine in pediatric patients with atopic dermatitis. Pediatr Dermatol 2007; 24:118–20. [DOI] [PubMed] [Google Scholar]
- 79. Su JC, Kemp AS, Varigos GA et al Atopic eczema: its impact on the family and financial cost. Arch Dis Child 1997; 76:159–62. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 80. Fitton F, Temple B, Acheson HW. The cost of prescribing in general practice. Soc Sci Med 1985; 21:1097–105. [DOI] [PubMed] [Google Scholar]
- 81. Silverberg JI. Health care utilization, patient costs, and access to care in US adults with eczema: a population‐based study. JAMA Dermatol 2015; 151:743–52. [DOI] [PubMed] [Google Scholar]
- 82. Bickers DR, Lim HW, Margolis D et al The burden of skin diseases: 2004. A joint project of the American Academy of Dermatology Association and the Society for Investigative Dermatology. J Am Acad Dermatol 2006; 55:490–500. [DOI] [PubMed] [Google Scholar]
- 83. Ellis CN, Drake LA, Prendergast MM et al Cost of atopic dermatitis and eczema in the United States. J Am Acad Dermatol 2002; 46:361–70. [DOI] [PubMed] [Google Scholar]
- 84. Fowler JF, Duh MS, Rovba L et al The direct and indirect cost burden of atopic dermatitis: an employer‐payer perspective. Manag Care Interface 2007; 20:26–32. [PubMed] [Google Scholar]
- 85. Suh DC, Sung J, Gause D et al Economic burden of atopic manifestations in patients with atopic dermatitis – analysis of administrative claims. J Manag Care Pharm 2007; 13:778–89. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 86. Fivenson D, Arnold RJ, Kaniecki DJ et al The effect of atopic dermatitis on total burden of illness and quality of life on adults and children in a large managed care organization. J Manag Care Pharm 2002; 8:333–42. [DOI] [PubMed] [Google Scholar]
- 87. Kim C, Park KY, Ahn S et al Economic impact of atopic dermatitis in Korean patients. Ann Dermatol 2015; 27:298–305. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 88. Barbeau M, Bpharm HL. Burden of atopic dermatitis in Canada. Int J Dermatol 2006; 45:31–6. [DOI] [PubMed] [Google Scholar]
- 89. Gieler U, Hohmann M, Niemeier V et al Cost evaluation in atopic eczema. J Dermatol Treat 1999; 10:S15–20. [Google Scholar]
- 90. Verboom P, Hakkaart‐Van L, Sturkenboom M et al The cost of atopic dermatitis in the Netherlands: an international comparison. Br J Dermatol 2002; 147:716–24. [DOI] [PubMed] [Google Scholar]
- 91. Jenner N, Campbell J, Marks R. Morbidity and cost of atopic eczema in Australia. Australas J Dermatol 2004; 45:16–22. [DOI] [PubMed] [Google Scholar]
- 92. Herd RM, Tidman MJ, Prescott RJ et al The cost of atopic eczema. Br J Dermatol 1996; 135:20–3. [PubMed] [Google Scholar]
- 93. Filanovsky MG, Pootongkam S, Tamburro JE et al The financial and emotional impact of atopic dermatitis on children and their families. J Pediatr 2016; 169:284–90. [DOI] [PubMed] [Google Scholar]
- 94. Onukwugha E, McRae J, Kravetz A et al Cost‐of‐illness studies: an updated review of current methods. Pharmacoeconomics 2016; 34:43–58. [DOI] [PubMed] [Google Scholar]
- 95. NICE . Guide to the methods of technology appraisal 2013. Available at: https://www.nice.org.uk/process/pmg9/chapter/foreword (last accessed 12 March 2019).
- 96. Gray AM, Rivero‐Arias O, Clarke PM. Estimating the association between SF‐12 responses and EQ‐5D utility values by response mapping. Med Decis Making 2006; 26:18–29. [DOI] [PubMed] [Google Scholar]
- 97. Brazier J, Roberts J, Deverill M. The estimation of a preference‐based measure of health from the SF‐36. J Health Econ 2002; 21:271–92. [DOI] [PubMed] [Google Scholar]
- 98. Abramovits W, Boguniewicz M, Prendergast MM et al Comparisons of efficacy and cost‐effectiveness of topical immunomodulators in the management of atopic dermatitis. J Med Econ 2003; 6:1–14. [Google Scholar]
- 99. Hjelmgren J, Svensson A, Jorgensen ET. Cost‐effectiveness of tacrolimus ointment vs. standard treatment in patients with moderate and severe atopic dermatitis: a health‐economic model simulation based on a patient survey and clinical trial data. Br J Dermatol 2007; 156:913–21. [DOI] [PubMed] [Google Scholar]
- 100. McManus E, Sach T, Levell N. The use of decision–analytic models in atopic eczema: a systematic review and critical appraisal. Pharmacoeconomics 2018; 36:51–66. [DOI] [PubMed] [Google Scholar]
- 101. NHS England . Items which should not routinely be prescribed in primary care: an update and a consultation on further guidance for CCGs. Available at: https://www.england.nhs.uk/wp-content/uploads/2018/11/06i-pb-28-11-2018-lpp-gff-annex-a-items-not-routinely-prescribed-update.pdf (last accessed 13 March 2019).
- 102. Howell M, Parker M, Mustelin T et al Past, present, and future for biologic intervention in atopic dermatitis. Allergy 2015; 70:887–96. [DOI] [PubMed] [Google Scholar]
- 103. Petrou S. Methodological issues raised by preference‐based approaches to measuring the health status of children. Health Econ 2003; 12:697–702. [DOI] [PubMed] [Google Scholar]
- 104. Heinl D, Prinsen CA, Drucker AM et al Measurement properties of quality of life measurement instruments for infants, children and adolescents with eczema: protocol for a systematic review. Syst Rev 2016; 5:25. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 105. Heinl D, Prinsen C, Sach T et al Measurement properties of quality‐of‐life measurement instruments for infants, children and adolescents with eczema: a systematic review. Br J Dermatol 2017; 176:878–89. [DOI] [PubMed] [Google Scholar]
- 106. Grob J‐J, Richard M‐A. Instruments génériques et spécifiques pour la mesure de QdV en dermatologie. Ann Dermatol Venereol 2000; 127 (Suppl. 2):2S9–12. [PubMed] [Google Scholar]
- 107. Herrmann M. [Treatment of atopic dermatitis with tacrolimus ointment is cost‐effective]. Aktuelle Derm 2008; 34:151 (in German). [Google Scholar]
- 108. Schmitt J. [Medical care and health‐economic relevance of atopic eczema]. Allergologie 2010; 33:279–88 (in German). [Google Scholar]
- 109. Fischer J, Gerber‐Grote A, Von Berg A. [A health economic analysis of the GINI (German Infant Nutritional Intervention) study: is the prevention of atopic dermatitis with hydrolysate foods in childhood cost‐effective?]. Haut 2014; 25:103–4 (in German). [Google Scholar]
- 110. Ehlken B, Mohrenschlager M, Kugland B et al [Cost‐of‐illness study in patients suffering from atopic eczema in Germany]. Hautarzt 2005; 56:1144–51 (in German). [DOI] [PubMed] [Google Scholar]
- 111. Yoon S‐M, Choi I‐H. The burden of atopic dermatitis on children and their families: quality of life and financial impact in Seoul area. J Korean Ophthalmol Otorhinolaryngol Dermatol 2010; 23:122–37. [Google Scholar]
- 112. Kim EJ, Kim HO, Park YM. A study on quality of life and economic burden in Korean patients with atopic dermatitis and their parents. Korean J Dermatol 2008; 46:160–70. [Google Scholar]
- 113. Kang K, Kim DH, Kim D. Utilization pattern and cost of medical treatment and complementary alternative therapy in children with atopic dermatitis. Allergy Asthma Respir Dis 2012; 22:27–36. [Google Scholar]
- 114. Yun Y, Choi I‐H. Quality of life and economic impact of adult atopic dermatitis patients in Seoul. J Korean Ophthalmol Otorhinolaryngol Dermatol 2010; 23:199–214. [Google Scholar]
- 115. Kim N‐K, Oh Y‐R, Seo E‐S. A research on quality of life and cost of Oriental medical care in adult patients with chronic atopic dermatitis in Korea. J Korean Ophthalmol Otorhinolaryngol Dermatol 2010; 23:215–23. [Google Scholar]
- 116. Kwen KN, Lee S, Won J et al A study on the correlation between quality of life and disease severity in adult patients with atopic dermatitis. J Korean Ophthalmol Otorhinolaryngol Dermatol 2011; 24:27–36. [Google Scholar]
- 117. Sánchez J, Sánchez A. Cardona R [Economic consequences in real life of allergen immunotherapy in asthma, rhinitis and dermatitis]. Rev Alerg Mex 2016; 63:323–33 (in Spanish). [DOI] [PubMed] [Google Scholar]
- 118. Moncrieff G, Lied‐Lied A, Nelson G et al Cost and effectiveness of prescribing emollient therapy for atopic eczema in UK primary care in children and adults: a large retrospective analysis of the Clinical Practice Research Datalink. BMC Dermatol 2018; 18:9. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 119. Santer M, Rumsby K, Ridd MJ et al Adding emollient bath additives to standard eczema management for children with eczema: the BATHE RCT. Health Technol Assess 2018; 2257. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 120. Santer M, Ridd MJ, Francis NA et al Emollient bath additives for the treatment of childhood eczema (BATHE): multicentre pragmatic parallel group randomised controlled trial of clinical and cost effectiveness. BMJ 2018; 361:k1332. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 121. Zimmermann M, Rind D, Chapman R et al Economic evaluation of dupilumab for moderate‐to‐severe atopic dermatitis: a cost‐utility analysis. J Drugs Dermatol 2018; 17:750–6. [PubMed] [Google Scholar]
- 122. Kwa L, Silverberg JI. Financial burden of emergency department visits for atopic dermatitis in the United States. J Am Acad Dermatol 2018; 79:443–7. [DOI] [PubMed] [Google Scholar]
- 123. Arima K, Gupta S, Gadkari A et al Burden of atopic dermatitis in Japanese adults: analysis of data from the 2013 National Health and Wellness Survey. J Dermatol 2018; 45:390–6. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 124. Narla S, Hsu DY, Thyssen JP et al Predictors of hospitalization, length of stay, and costs of care among adult and pediatric inpatients with atopic dermatitis in the United States. Dermatitis 2018; 29:22–31. [DOI] [PubMed] [Google Scholar]
- 125. Eckert L, Gupta S, Amand C et al The burden of atopic dermatitis in US adults: health care resource utilization data from the 2013 National Health and Wellness Survey. J Am Acad Dermatol 2018; 78:54–61. [DOI] [PubMed] [Google Scholar]
- 126. Kuznik A, Bégo‐Le‐Bagousse G, Eckert L et al Economic evaluation of dupilumab for the treatment of moderate‐to‐severe atopic dermatitis in adults. Dermatol Ther 2017; 7:493–505. [DOI] [PMC free article] [PubMed] [Google Scholar]
Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Supplementary Materials
Table S1 Characteristics of the cost analyses, outcome studies and feasibility study.
Table S2 Cost‐of‐illness study characteristics.
Table S3 Overview of the economic evaluations of interventions for eczema.
Table S4 Reporting quality assessment of the full economic evaluations according to the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist.
Video S1 Author video.