Cost-effectiveness of prophylactic moisturization for atopic dermatitis

Shuai Xu*, Supriya Immaneni, Gordon B. Hazen, Jonathan I. Silverberg, Amy S. Paller, Peter A. Lio

*Corresponding author for this work

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

IMPORTANCE Emerging evidence suggests that the use of moisturizers on newborns and infants (ie, from birth to 6 months of age) is potentially helpful in preventing the development of atopic dermatitis. OBJECTIVE To investigate the cost-effectiveness of using a daily moisturizer as prevention against atopic dermatitis among high-risk newborns. DESIGN, SETTING, AND PARTICIPANTS In a cost-effectiveness analysis, the average cost of total-body moisturization using 7 common moisturizers from birth to 6 months of age was determined for male and female infants.We assumed the same unit of weight per moisturizer used for a given body surface area. Based on previously reported data (relative risk reduction of 50%), the incremental gain in quality-adjusted life-years (QALYs) was determined using a 6-month time window. The cost-effectiveness of each moisturizer was determined by assuming equal efficacy. A sensitivity analysis was conducted by varying the relative risk from 0.28 to 0.90. INTERVENTIONS Use of prophylactic moisturizing compounds. MAIN OUTCOMES AND MEASURES The primary outcomeswere the incremental cost-effectiveness values ($/QALY) for each moisturizer in preventing atopic dermatitis during a 6-month time window. RESULTS The calculated amount of daily all-body moisturizer needed at birth was 3.6 g (0.12 oz) per application, which increased to 6.6 g (0.22 oz) at 6 months of age. Of the 7 products evaluated, the average price was $1.07/oz (range, $0.13/oz-$2.96/oz). For a 6-month time window, the average incremental QALY benefit was 0.021. The sensitivity analysis showed that the incremental gain of QALY ranged from 0.0041 to 0.030. Petrolatum was the most cost-effective ($353/QALY [95%CI, $244-$1769/QALY) moisturizer in the cohort. Even assuming the lowest incremental QALYs for the most expensive moisturizer, the intervention was still less than $45 000/QALY. CONCLUSIONS AND RELEVANCE Overall, atopic dermatitis represents a major health expenditure and has been associated with multiple comorbidities. Daily moisturization may represent a cost-effective, preventative strategy to reduce the burden of atopic dermatitis.

Original languageEnglish (US)
Article numbere163909
JournalJAMA Pediatrics
Volume171
Issue number2
DOIs
StatePublished - Feb 1 2017

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Quality-Adjusted Life Years
Atopic Dermatitis
Cost-Benefit Analysis
Parturition
Costs and Cost Analysis
Newborn Infant
Petrolatum
Body Surface Area
Risk Reduction Behavior
Health Expenditures
Comorbidity
Weights and Measures

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

@article{4aa8cb7188404179b8b521f836c93376,
title = "Cost-effectiveness of prophylactic moisturization for atopic dermatitis",
abstract = "IMPORTANCE Emerging evidence suggests that the use of moisturizers on newborns and infants (ie, from birth to 6 months of age) is potentially helpful in preventing the development of atopic dermatitis. OBJECTIVE To investigate the cost-effectiveness of using a daily moisturizer as prevention against atopic dermatitis among high-risk newborns. DESIGN, SETTING, AND PARTICIPANTS In a cost-effectiveness analysis, the average cost of total-body moisturization using 7 common moisturizers from birth to 6 months of age was determined for male and female infants.We assumed the same unit of weight per moisturizer used for a given body surface area. Based on previously reported data (relative risk reduction of 50{\%}), the incremental gain in quality-adjusted life-years (QALYs) was determined using a 6-month time window. The cost-effectiveness of each moisturizer was determined by assuming equal efficacy. A sensitivity analysis was conducted by varying the relative risk from 0.28 to 0.90. INTERVENTIONS Use of prophylactic moisturizing compounds. MAIN OUTCOMES AND MEASURES The primary outcomeswere the incremental cost-effectiveness values ($/QALY) for each moisturizer in preventing atopic dermatitis during a 6-month time window. RESULTS The calculated amount of daily all-body moisturizer needed at birth was 3.6 g (0.12 oz) per application, which increased to 6.6 g (0.22 oz) at 6 months of age. Of the 7 products evaluated, the average price was $1.07/oz (range, $0.13/oz-$2.96/oz). For a 6-month time window, the average incremental QALY benefit was 0.021. The sensitivity analysis showed that the incremental gain of QALY ranged from 0.0041 to 0.030. Petrolatum was the most cost-effective ($353/QALY [95{\%}CI, $244-$1769/QALY) moisturizer in the cohort. Even assuming the lowest incremental QALYs for the most expensive moisturizer, the intervention was still less than $45 000/QALY. CONCLUSIONS AND RELEVANCE Overall, atopic dermatitis represents a major health expenditure and has been associated with multiple comorbidities. Daily moisturization may represent a cost-effective, preventative strategy to reduce the burden of atopic dermatitis.",
author = "Shuai Xu and Supriya Immaneni and Hazen, {Gordon B.} and Silverberg, {Jonathan I.} and Paller, {Amy S.} and Lio, {Peter A.}",
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Cost-effectiveness of prophylactic moisturization for atopic dermatitis. / Xu, Shuai; Immaneni, Supriya; Hazen, Gordon B.; Silverberg, Jonathan I.; Paller, Amy S.; Lio, Peter A.

In: JAMA Pediatrics, Vol. 171, No. 2, e163909, 01.02.2017.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Cost-effectiveness of prophylactic moisturization for atopic dermatitis

AU - Xu, Shuai

AU - Immaneni, Supriya

AU - Hazen, Gordon B.

AU - Silverberg, Jonathan I.

AU - Paller, Amy S.

AU - Lio, Peter A.

PY - 2017/2/1

Y1 - 2017/2/1

N2 - IMPORTANCE Emerging evidence suggests that the use of moisturizers on newborns and infants (ie, from birth to 6 months of age) is potentially helpful in preventing the development of atopic dermatitis. OBJECTIVE To investigate the cost-effectiveness of using a daily moisturizer as prevention against atopic dermatitis among high-risk newborns. DESIGN, SETTING, AND PARTICIPANTS In a cost-effectiveness analysis, the average cost of total-body moisturization using 7 common moisturizers from birth to 6 months of age was determined for male and female infants.We assumed the same unit of weight per moisturizer used for a given body surface area. Based on previously reported data (relative risk reduction of 50%), the incremental gain in quality-adjusted life-years (QALYs) was determined using a 6-month time window. The cost-effectiveness of each moisturizer was determined by assuming equal efficacy. A sensitivity analysis was conducted by varying the relative risk from 0.28 to 0.90. INTERVENTIONS Use of prophylactic moisturizing compounds. MAIN OUTCOMES AND MEASURES The primary outcomeswere the incremental cost-effectiveness values ($/QALY) for each moisturizer in preventing atopic dermatitis during a 6-month time window. RESULTS The calculated amount of daily all-body moisturizer needed at birth was 3.6 g (0.12 oz) per application, which increased to 6.6 g (0.22 oz) at 6 months of age. Of the 7 products evaluated, the average price was $1.07/oz (range, $0.13/oz-$2.96/oz). For a 6-month time window, the average incremental QALY benefit was 0.021. The sensitivity analysis showed that the incremental gain of QALY ranged from 0.0041 to 0.030. Petrolatum was the most cost-effective ($353/QALY [95%CI, $244-$1769/QALY) moisturizer in the cohort. Even assuming the lowest incremental QALYs for the most expensive moisturizer, the intervention was still less than $45 000/QALY. CONCLUSIONS AND RELEVANCE Overall, atopic dermatitis represents a major health expenditure and has been associated with multiple comorbidities. Daily moisturization may represent a cost-effective, preventative strategy to reduce the burden of atopic dermatitis.

AB - IMPORTANCE Emerging evidence suggests that the use of moisturizers on newborns and infants (ie, from birth to 6 months of age) is potentially helpful in preventing the development of atopic dermatitis. OBJECTIVE To investigate the cost-effectiveness of using a daily moisturizer as prevention against atopic dermatitis among high-risk newborns. DESIGN, SETTING, AND PARTICIPANTS In a cost-effectiveness analysis, the average cost of total-body moisturization using 7 common moisturizers from birth to 6 months of age was determined for male and female infants.We assumed the same unit of weight per moisturizer used for a given body surface area. Based on previously reported data (relative risk reduction of 50%), the incremental gain in quality-adjusted life-years (QALYs) was determined using a 6-month time window. The cost-effectiveness of each moisturizer was determined by assuming equal efficacy. A sensitivity analysis was conducted by varying the relative risk from 0.28 to 0.90. INTERVENTIONS Use of prophylactic moisturizing compounds. MAIN OUTCOMES AND MEASURES The primary outcomeswere the incremental cost-effectiveness values ($/QALY) for each moisturizer in preventing atopic dermatitis during a 6-month time window. RESULTS The calculated amount of daily all-body moisturizer needed at birth was 3.6 g (0.12 oz) per application, which increased to 6.6 g (0.22 oz) at 6 months of age. Of the 7 products evaluated, the average price was $1.07/oz (range, $0.13/oz-$2.96/oz). For a 6-month time window, the average incremental QALY benefit was 0.021. The sensitivity analysis showed that the incremental gain of QALY ranged from 0.0041 to 0.030. Petrolatum was the most cost-effective ($353/QALY [95%CI, $244-$1769/QALY) moisturizer in the cohort. Even assuming the lowest incremental QALYs for the most expensive moisturizer, the intervention was still less than $45 000/QALY. CONCLUSIONS AND RELEVANCE Overall, atopic dermatitis represents a major health expenditure and has been associated with multiple comorbidities. Daily moisturization may represent a cost-effective, preventative strategy to reduce the burden of atopic dermatitis.

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