title: Cost-effectiveness of Prophylactic Moisturization for Atopic Dermatitis.
abstract: 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.
  
  
  
  To investigate the cost-effectiveness of using a daily moisturizer as prevention against atopic dermatitis among high-risk newborns.
  
  
  
  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.
  
  
  
  Use of prophylactic moisturizing compounds.
  
  
  
  The primary outcomes were the incremental cost-effectiveness values ($/QALY) for each moisturizer in preventing atopic dermatitis during a 6-month time window.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Shuai
authors.initials: S
authors.lastname: Xu
authors.affiliation: Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Supriya
authors.initials: S
authors.lastname: Immaneni
authors.affiliation: Department of Industrial Engineering and Management Sciences, Northwestern University, Chicago, Illinois.
authors.forename: Gordon B
authors.initials: GB
authors.lastname: Hazen
authors.affiliation: Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Jonathan I
authors.initials: JI
authors.lastname: Silverberg
authors.affiliation: Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Amy S
authors.initials: AS
authors.lastname: Paller
authors.affiliation: Chicago Integrative Eczema Center, Chicago, Illinois.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Lio
mesh_terms: D003362:Cost-Benefit Analysis; D003876:Dermatitis, Atopic / Q000191:economics* / Q000517:prevention & control*; D004643:Emollients / Q000191:economics*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D019057:Quality-Adjusted Life Years
chemical_list: D004643:Emollients