{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:35Z","timestamp":1791417635058,"version":"4.3.3"},"reference-count":41,"publisher":"American Medical Association (AMA)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Dermatol"],"published-print":{"date-parts":[[2024,11,1]]},"abstract":"<jats:sec id=\"ab-drv240003-4\"><jats:title>Importance<\/jats:title><jats:p>Although treatment for chronic urticaria (CU) has improved over the past decades, evidence regarding costs and net benefits associated with these treatment strategies have yet to be comprehensively characterized and synthesized.<\/jats:p><\/jats:sec><jats:sec id=\"ab-drv240003-5\"><jats:title>Objective<\/jats:title><jats:p>To summarize the cost and cost-effectiveness of CU management strategies.<\/jats:p><\/jats:sec><jats:sec id=\"ab-drv240003-6\"><jats:title>Evidence Review<\/jats:title><jats:p>An extensive systematic literature search of 6 databases (MEDLINE, Embase, PubMed Cochrane, Scopus, and CINAHL) and gray literature sources, without language restriction, was conducted and updated to March 23, 2024. Articles that performed cost analysis or full economic evaluation among patients with CU were included. Two reviewers independently extracted data, such as annual costs of health care services or incremental cost-effectiveness ratio (ICER) per quality-adjusted life-year (QALY). All monetary values were converted and inflated to 2023 US dollars. Evidence-based synthesis for health benefit was judged using the Evidence Rating Matrix by the Institute for Clinical and Economic Review.<\/jats:p><\/jats:sec><jats:sec id=\"ab-drv240003-7\"><jats:title>Findings<\/jats:title><jats:p>Seventeen unique studies (11 cost analysis studies and 6 full economic evaluations) were included. With the wide variation in health care resources, services that included biologic omalizumab utilization had higher annual health care cost estimations for CU management than services that did not include omalizumab prescription (median [IQR] cost, $6933 [$5988-$8717] vs $5621 [$2488-$8754]). The biologic omalizumab, 300 mg, for H<jats:sub>1<\/jats:sub> antihistamine\u2013refractory chronic spontaneous urticaria (CSU) (3 studies) was found to have a median (IQR) ICER of $89\u202f005 ($36\u202f058-$145\u202f694) per QALY (evidence rating as incremental or better; moderate certainty with substantial net health benefit). Routine laboratory testing among patients with CSU with otherwise normal histories and physical examination findings (1 study) had ICERs ranging from $1\u202f427\u202f928 to $1\u202f950\u202f524 per QALY (evidence rating as comparable or inferior; moderate certainty that the net health benefit is inferior).<\/jats:p><\/jats:sec><jats:sec id=\"ab-drv240003-8\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>With limited evidence of cost-effectiveness, biologic omalizumab, 300 mg, for H<jats:sub>1<\/jats:sub> antihistamine\u2013refractory CSU was found to be cost-effective in US health care services at the willingness to pay threshold of $150\u202f000 per QALY. Meanwhile, routine laboratory testing among patients with CSU without compelling indication was not cost-effective. Future studies in more diverse CU populations and resource settings are needed to fill evidence gaps.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamadermatol.2024.2863","type":"journal-article","created":{"date-parts":[[2024,8,28]],"date-time":"2024-08-28T15:32:52Z","timestamp":1724859172000},"page":"1225","source":"Crossref","is-referenced-by-count":7,"title":["Cost and Cost-Effectiveness of the Management Strategies of Chronic Urticaria"],"prefix":"10.1001","volume":"160","author":[{"given":"Surapon","family":"Nochaiwong","sequence":"first","affiliation":[{"name":"Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand"},{"name":"Pharmacoepidemiology and Statistics Research Center (PESRC), Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mati","family":"Chuamanochan","sequence":"additional","affiliation":[{"name":"Pharmacoepidemiology and Statistics Research Center 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