Prophylactic Moisturizing May Help Protect Infants from Atopic Dermatitis
Daily application of petroleum jelly for the first 6 months of an infant's life can provide effective protection against atopic dermatitis, equating to a cost benefit of $353 per quality-adjusted life year (QALY).
Recent research has shown that regular moisturizing can prevent the development of atopic dermatitis in at-risk infants (Horimukai K, Morita K, Narita M, et al. J Allergy Clin Immunol 2014;134(4):824-830. and Simpson EL, Chalmers JR, Hanifin JM, et al. J Allergy Clin Immunol. 2014;134(4):818-823). Based on these results researchers at Northwestern University Chicago and The Chicago Integrative Eczema Center sought to discover the cost benefit among seven different common moisturizers for the prevention of atopic dermatitis in high-risk newborns.
The incremental gain in QALYs was determined using a 6-month time window, based on previously reported data (relative risk reduction 50%).
Of the seven products evaluated, the average price was $1.07/oz (range, $0.13/oz-$2.96/oz) and the average incremental QALY benefit was 0.021. The incremental gain of QALY ranged from 0.0041 to 0.030. Petroleum jelly was the most affordable ($7.30 for 6 months of use); assuming equal efficacy among moisturizers, petrolatum was most cost-effective at $353 per QALY.
“There's an important economic argument to be made here,” said lead author, Dr. Steve Xu, “Moisturizers are an important intervention dermatologists use to treat eczema. They play a big role in getting our patients better. But insurers do not usually cover the cost of moisturizers. We're arguing for their inclusion in health insurance coverage."
In addition to improving outcomes in atopic dermatitis, the researchers are looking into whether prophylactic moisturizing can help reduce other health problems such as food allergies; larger, long-term studies are needed to fully understand the potential benefits.
It is estimated that 20% of children in the U.S. are impacted by eczema, which costs the U.S. healthcare system $3.8 billion each year (Ellis CN, Drake LA, Prendergast MM, et al. J Am Acad Dermatol. 2002;46(3):361-370.)
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