Health Economics Group, Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ, U.K.
Dermatology Department, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich, NR4 7UY, U.K.
Br J Dermatol. 2019 Oct;181(4):707-716. doi: 10.1111/bjd.17696. Epub 2019 Apr 11.
Atopic eczema is an inflammatory skin condition, with a similar impact on health-related quality of life as other chronic diseases. Increasing pressures on resources within the National Health Service increase the importance of having good economic evidence to inform their allocation.
To educate dermatologists about economic methods with reference to currently available economic evidence on eczema.
The role of different types of economic evidence is illustrated by evidence found in a systematic literature search conducted across 12 online databases up to 22 May 2017. Primary empirical studies either reporting the results of a cost-of-illness study or evaluating the cost, utility or full economic evaluation of interventions for preventing or treating eczema were included. Two reviewers independently assessed studies for eligibility and performed data abstraction, with disagreements resolved by a third reviewer. Evidence tables of results were produced for narrative discussion. The reporting quality of economic evaluations was assessed.
Seventy-eight studies (described in 80 papers) were deemed eligible. Thirty-three (42%) were judged to be economic evaluations, 12 (15%) cost analyses, six (8%) utility analyses, 26 (33%) cost-of-illness studies and one a feasibility study (1%). The calcineurin inhibitors tacrolimus and pimecrolimus, as well as barrier creams, had the most economic evidence available. Partially hydrolysed infant formula was the most commonly evaluated prevention.
The current level of economic evidence for interventions aimed at preventing and treating eczema is limited compared with that available for clinical outcomes, suggesting that greater collaboration between clinicians and economists might be beneficial.
特应性皮炎是一种炎症性皮肤疾病，对健康相关生活质量的影响与其他慢性病相似。由于国家卫生服务系统的资源压力不断增加，因此需要有良好的经济证据来为其分配提供依据，这一点变得愈发重要。
通过参考目前关于特应性皮炎的经济证据，向皮肤科医生介绍经济方法。
通过对截至 2017 年 5 月 22 日在 12 个在线数据库中进行的系统文献检索中找到的证据，说明了不同类型经济证据的作用。纳入的研究包括报告疾病成本研究结果或评估预防或治疗特应性皮炎的干预措施的成本、效用或全面经济评估的原始实证研究。两位评审员独立评估研究的合格性并进行数据提取，如有分歧则由第三位评审员解决。制作了证据表以进行叙述性讨论。评估了经济评估的报告质量。
78 项研究（在 80 篇论文中描述）被认为符合条件。其中 33 项（42%）被判定为经济评估，12 项（15%）为成本分析，6 项（8%）为效用分析，26 项（33%）为疾病成本研究，1 项（1%）为可行性研究。钙调磷酸酶抑制剂他克莫司和吡美莫司以及屏障霜具有最多的经济证据。部分水解配方奶粉是最常评估的预防方法。
与临床结果相比，目前针对预防和治疗特应性皮炎的干预措施的经济证据有限，这表明临床医生和经济学家之间可能需要进行更多的合作。
