A Systematic Review of the Cost Concerns of Eczema Treatments

The big idea:

• This study aims to review all the economic evidence about eczema treatments and prevention at any age.

• By looking at the current economic studies on eczema, this research will help improve the evidence needed for making decisions about which treatments are most cost-effective.

What the study asked: 

1. What type of health economic evidence has been used in the evaluation of the prevention and treatment of atopic eczema?

2. Are interventions to prevent and treat atopic eczema cost effective?

3. What is the quality of health economic evidence for the prevention and treatment of atopic eczema?

4. What are the current gaps in existing research?

What the study did:

1. Literature Search

   1. The team searched many databases (such as MEDLINE, EMBASE, Cochrane, Scopus, EconLit, and NHS Economic Evaluation Database) for studies on the costs or cost-effectiveness of eczema treatments.

   2. There was no date limit, and duplicates were removed.

   3. The team also checked reference lists and contacted authors for unpublished studies.

2. Eligible Studies

   1. Studies were included if they reported costs or economic outcomes for eczema treatments, including full economic evaluations (like cost-effectiveness) or partial analyses.

   2. All study designs and settings were eligible.

   3. Only full-text English papers published before October 9, 2015, were included.

3. Study Selection and Data Collection

   1. Two reviewers independently checked titles, abstracts, and full texts for inclusion.

   2. Disagreements involved a third reviewer.

   3. Data was extracted using a standardised Excel form, piloted first to ensure consistency.

   4. The focus was on methods, results, and study quality, and any gaps or strengths will be identified.

4. Analysis

   1. As studies differed greatly, results were not combined into a meta-analysis. Instead, findings were discussed in a qualitative or narrative way.

What the study found:

• Eczema had its financial costs.

  • In the 1990s, eczema in young children cost the UK around £47 million per year, and total costs for all ages were estimated at £465 million.

  • These estimates are now outdated, especially as new treatments such as biologics have become available.

• Despite eczema being common, there are still many unknowns about how to prevent and treat eczema.

  • To tackle this issue, the James Lind Alliance (JLA) set up a Priority Setting Partnership (PSP) for eczema in 2010, which brought patients, carers, and health professionals together to identify 14 key treatment uncertainties.

• To track what works, the GREAT database collects over 600 studies and trials on eczema treatments.

  • However, it does not include economic evidence, which is important for understanding costs and planning resources.

  • So far, NICE has only considered economic models for two areas: an educational program for children under 12 and two eczema drugs (tacrolimus and pimecrolimus). 

    
    

What this means for eczema:

• Eczema is very common and costly, but there isn’t enough strong economic evidence to clearly show which treatments or prevention methods give the best value for money.

• Current research is fragmented and outdated, especially with newer treatments now available, making it harder for healthcare systems to make informed decisions.

• Overall, more high-quality studies are needed to guide cost-effective eczema care.

Link to study: https://link.springer.com/article/10.1186/s13643-016-0262-0