Cost effectiveness of management of mild-to-moderate atopic dermatitis with 1% pimecrolimus cream in children and adolescents 2-17 years of age.
BACKGROUND
Atopic dermatitis (AD) has the potential to cause a long-term economic impact on patients, their families, and the healthcare system.


OBJECTIVE
To determine if 1% pimecrolimus cream is cost-effective in treating mild-to-moderate AD in patients 2-17 years of age.


METHODS
Data on the efficacy of AD management with 1% pimecrolimus cream (Elidel, Novartis Pharma GmbH, Wehr, Germany) were obtained from a 12-month, randomized, double-blind, multinational, controlled clinical trial comparing pimecrolimus and conventional therapy. Markov modeling was used for the economic model, based on: (i) Investigator's Global Assessment scores assessed at each visit during the clinical trial; (ii) estimated costs for medication and physician visits for each level of disease severity; and (iii) utility values for each level of disease severity. The perspective was that of a third-party payer.


RESULTS
In 2004 US dollars, the incremental cost-effectiveness of 1% pimecrolimus cream was 38,231 US dollars per quality-adjusted life year (QALY) gained compared with conventional therapy. Sensitivity analyses showed a range of 27,299 US dollarsto 63,457 US dollars per QALY gained.


CONCLUSIONS
With an incremental cost-effectiveness ratio of <50,000 US dollars per QALY gained, 1% pimecrolimus cream offers a cost-effective therapeutic option in the management of AD.
Ellis
Charles N
CN
Department of Dermatology, University of Michigan Medical School, Ann Arbor, USA.
Kahler
Kristijan H
KH
Grueger
Jens
J
Chang
Jane
J
D000287:Administration, Topical; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D003876:Dermatitis, Atopic / Q000188:drug therapy*; D003879:Dermatologic Agents / Q000191:economics* / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D019057:Quality-Adjusted Life Years; D016032:Randomized Controlled Trials as Topic; D016559:Tacrolimus / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use
D003879:Dermatologic Agents; C117268:pimecrolimus; D016559:Tacrolimus