Cost-effectiveness of Prophylactic Moisturization for Atopic Dermatitis
Open accessAbstract
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 outcomes were 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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Early, consistent application of emollients for infants at increased risk results in a 30-50% reduction in the diagnosis of atopic dermatitis at 6 months.
“This simple and cost-effective approach has resulted in a 30–50% reduction in the diagnosis of AD at 6 months [25–27].”
From Atopic dermatitis (2018) · cites this paper as [27]
The paper’s introductory passage reports that early full-body moisturization in high-risk infants was associated with reduced atopic dermatitis incidence, and the Methods use a previously reported 50% relative risk reduction. But the passage gives 25% for the Japanese cohort, not 30%, and describes application over 6–8 months rather than a reduction measured uniformly at 6 months. (LLM, conf=0.84)
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References 25 · Cited by 47
- Authors
- Xu, S., Immaneni, S., Hazen, G. B., Silverberg, J. I., Paller, A. S., & Lio, P. A.
- Affiliations
- Northwestern University (US)
- Chicago Integrative Eczema Center, Chicago, Illinois
- Corresponding author
- Xu, Shuai
- Venue
- JAMA Pediatrics
- Publisher
- American Medical Association (AMA)
- Published
- 2017-02-06
- Volume
- 171
- Issue
- 2
- Pages
- e163909
- ISSN
- 1072-4710 (ISSN-L)
- 2168-6203
- OpenAlex
- W2560647422
- Cited by
- 47
- References
- 25
- Citations by year
- 2025: 1 · 2024: 5 · 2023: 3 · 2022: 8 · 2021: 6 · 2020: 7 · 2019: 3 · 2018: 3 · 2017: 10 · 2016: 1
- FWCI
- 6.80
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Archives of Pediatrics and Adolescent Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Health Professions › Speech and Hearing › Neonatal skin health care
- Keywords
- atopic dermatitis, infant skin care, cost-effectiveness, petrolatum, quality-adjusted life years, atopic dermatitis prevention, high-risk infants, relative risk reduction
- MeSH terms
- Cost-Benefit Analysis, Dermatitis, Atopic, Emollients, Female, Humans, Infant, Infant, Newborn, Male, Quality-Adjusted Life Years
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