Cost effectiveness of management of mild-to-moderate atopic dermatitis with 1% pimecrolimus cream in children and adolescents 2-17 years of age

Introduction: Atopic dermatitis (AD) has the potential to cause a long-term economic impact on patients, their families, and the healthcare system. Objective: To determine if 1% pimecrolimus cream is cost-effective in treating mild-to-moderate AD in patients 2-17 years of age. Methods: Data on the efficacy of AD management with 1% pimecrolimus cream (Elidel(R), Novartis Pharma GmbH, Wehr, Germany) were obtained from a 12-month, randomized, double-blind, multinational, controlled clinical trial comparing pimecrolimus and conventional therapy. Markov modeling was used for the economic model, based on: (i) Investigator's Global Assessment scores assessed at each visit during the clinical trial; (ii) estimated costs for medication and physician visits for each level of disease severity; and (iii) utility values for each level of disease severity. The perspective was that of a third-party payer. Results: In 2004 US dollars, the incremental cost-effectiveness of 1% pimecrolimus cream was $US38 231 per quality-adjusted life year (QALY) gained compared with conventional therapy. Sensitivity analyses showed a range of $US27 299 to $US63 457 per QALY gained. Conclusion: With an incremental cost-effectiveness ratio of <$US50 000 per QALY gained, 1% pimecrolimus cream offers a cost-effective therapeutic option in the management of AD.