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.
BACKGROUND
Atopic dermatitis (AD) affects health and quality of life and it has great impact on both health-care costs and costs to the society.


OBJECTIVE
The objective of this study was to develop a model to analyse the cost-effectiveness of a barrier-strengthening moisturizing cream as maintenance therapy compared with no treatment after initial treatment with betamethasone valerate in adult patients with AD in Sweden. A further aim was to apply a similar health-economic analysis for Denmark, Norway and Finland.


METHODS
A Markov simulation model was developed including data from three sources: (i) efficacy data from a randomized controlled trial including patients with moderate AD treated with either a moisturizing cream or no treatment, (ii) resource utilization and quality of life data, and (iii) unit prices from official price lists. A societal perspective was used and the analysis was performed according to treatment practice in Sweden. The model simulation was also applied for Denmark, Norway and Finland with inclusion of country-specific unit costs. Sensitivity analyses were performed to test the robustness of the results.


RESULTS
The results from the present analyses of treatment for patients with moderate AD indicate that maintenance treatment with a moisturizing cream during eczema-free periods could be cost-effective in a societal perspective. Similar results were obtained for Sweden, Denmark, Norway and Finland.


CONCLUSIONS
According to the analysis, treatment with a moisturizing cream was found to be a cost-effective option compared with no treatment in eczema-free periods in adult patients with AD in the four Nordic countries.
IHE, The Swedish Institute for Health Economics, Lund, Sweden. fh@ihe.se
F
F
Hjalte
C
C
Asseburg
G R
GR
Tennvall
D001624:Betamethasone Valerate / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D003718:Denmark; D003876:Dermatitis, Atopic / Q000188:drug therapy* / Q000191:economics*; D004643:Emollients / Q000191:economics* / Q000627:therapeutic use*; D005387:Finland; D005938:Glucocorticoids / Q000627:therapeutic use; D017048:Health Care Costs; D005102:Health Expenditures; D006801:Humans; D008390:Markov Chains; D017059:Models, Econometric; D009664:Norway; D011320:Primary Health Care / Q000191:economics; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D013548:Sweden
D004643:Emollients; D005938:Glucocorticoids; D001624:Betamethasone Valerate