Abstract
Objective:
To estimate the cost-effectiveness of online behavioral interventions (EczemaCareOnline.org.uk) designed tosupport eczema self-care management for parents/carers and young people from an NHS perspective.
Methods:
Two within-trial economic evaluations, using regression-based approaches, adjusting for baseline and pre-specifed confounder variables, were undertaken alongside two independent, pragmatic, parallel group, unmasked randomized controlled trials, recruiting through primary care. Trial 1 recruited 340 parents/carers of children aged 0–12 years and Trial 2 337 young people aged 13–25 years with eczema scored≥5 on Patient-Oriented Eczema Measure (POEM). Participants were randomized (1:1) to online intervention plus usual care or usual care alone. Resource use, collected via medical notes review, was valued using published unit costs in UK £Sterling 2021. Quality-of-life was elicited using proxy CHU-9D in Trial 1 and self-report EQ-5D-5L in Trial 2.
Results:
The intervention was dominant (cost saving and more effective) with a high probability of cost-effectiveness (>68%) in most analyses. The exception was the complete case cost–utility analysis for Trial 1 (omitting participants with children aged<2), with adjusted incremental cost savings of -£34.15 (95% CI – 104.54 to 36.24) and incremental QALYs of – 0.003 (95% CI – 0.021 to 0.015) producing an incremental cost per QALY of £12,466. In the secondary combined (Trials 1 and 2) cost-effectiveness analysis, the adjusted incremental cost was -£20.35 (95% CI – 55.41 to 14.70) with incremental success (≥2-point change on POEM) of 10.3% (95% CI 2.3–18.1%).
Conclusion:
The free at point of use online eczema self-management intervention was low cost to run and cost-effective.
Trial registration:
This trial was registered prospectively with the ISRCTN registry (ISRCTN79282252). URL www.EczemaCareOnline.org.uk.
To estimate the cost-effectiveness of online behavioral interventions (EczemaCareOnline.org.uk) designed tosupport eczema self-care management for parents/carers and young people from an NHS perspective.
Methods:
Two within-trial economic evaluations, using regression-based approaches, adjusting for baseline and pre-specifed confounder variables, were undertaken alongside two independent, pragmatic, parallel group, unmasked randomized controlled trials, recruiting through primary care. Trial 1 recruited 340 parents/carers of children aged 0–12 years and Trial 2 337 young people aged 13–25 years with eczema scored≥5 on Patient-Oriented Eczema Measure (POEM). Participants were randomized (1:1) to online intervention plus usual care or usual care alone. Resource use, collected via medical notes review, was valued using published unit costs in UK £Sterling 2021. Quality-of-life was elicited using proxy CHU-9D in Trial 1 and self-report EQ-5D-5L in Trial 2.
Results:
The intervention was dominant (cost saving and more effective) with a high probability of cost-effectiveness (>68%) in most analyses. The exception was the complete case cost–utility analysis for Trial 1 (omitting participants with children aged<2), with adjusted incremental cost savings of -£34.15 (95% CI – 104.54 to 36.24) and incremental QALYs of – 0.003 (95% CI – 0.021 to 0.015) producing an incremental cost per QALY of £12,466. In the secondary combined (Trials 1 and 2) cost-effectiveness analysis, the adjusted incremental cost was -£20.35 (95% CI – 55.41 to 14.70) with incremental success (≥2-point change on POEM) of 10.3% (95% CI 2.3–18.1%).
Conclusion:
The free at point of use online eczema self-management intervention was low cost to run and cost-effective.
Trial registration:
This trial was registered prospectively with the ISRCTN registry (ISRCTN79282252). URL www.EczemaCareOnline.org.uk.
| Original language | English |
|---|---|
| Pages (from-to) | 1165-1176 |
| Number of pages | 12 |
| Journal | European Journal of Health Economics |
| Volume | 25 |
| Issue number | 7 |
| Early online date | 9 Jan 2024 |
| DOIs | |
| Publication status | Published - 1 Sept 2024 |
Bibliographical note
Publisher Copyright:© The Author(s) 2024.