{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T16:55:18Z","timestamp":1782233718942,"version":"3.54.5"},"reference-count":23,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,8,13]],"date-time":"2023-08-13T00:00:00Z","timestamp":1691884800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Experimental Allergy"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Recent discoveries have led to the suggestion that enhancing skin barrier from birth might prevent eczema and food allergy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the cost\u2010effectiveness of daily all\u2010over\u2010body application of emollient during the first year of life for preventing atopic eczema in high\u2010risk children at 2\u2009years from a health service perspective. We also considered a 5\u2010year time horizon as a sensitivity analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A within\u2010trial economic evaluation using data on health resource use and quality of life captured as part of the BEEP trial alongside the trial data. Parents\/carers of 1394 infants born to families at high risk of atopic disease were randomised 1:1 to the emollient group, which were advised to apply emollient (Doublebase Gel or Diprobase Cream) to their child at least once daily to the whole body during the first year of life or usual care. Both groups received advice on general skin care. The main economic outcomes were incremental cost\u2010effectiveness ratio (ICER), defined as incremental cost per percentage decrease in risk of eczema in the primary cost\u2010effectiveness analysis. Secondary analysis, undertaken as a cost\u2010utility analysis, reports incremental cost per Quality\u2010Adjusted Life Year (QALY) where child utility was elicited using the proxy CHU\u20109D at 2\u2009years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At 2\u2009years, the adjusted incremental cost was \u00a387.45 (95% CI \u221254.31, 229.27) per participant, whilst the adjusted proportion without eczema was 0.0164 (95% CI \u22120.0329, 0.0656). The ICER was \u00a35337 per percentage decrease in risk of eczema. Adjusted incremental QALYs were very slightly improved in the emollient group, 0.0010 (95% CI \u22120.0069, 0.0089). At 5\u2009years, adjusted incremental costs were lower for the emollient group, \u2212\u00a3106.89 (95% CI \u2212354.66, 140.88) and the proportion without eczema was \u22120.0329 (95% CI \u22120.0659, 0.0002). The 5\u2010year ICER was \u00a33201 per percentage decrease in risk of eczema. However, when inpatient costs due to wheezing were excluded, incremental costs were lower and incremental effects greater in the usual care group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In line with effectiveness endpoints, advice given in the BEEP trial to apply daily emollient during infancy for eczema prevention in high\u2010risk children does not appear cost\u2010effective.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cea.14381","type":"journal-article","created":{"date-parts":[[2023,8,14]],"date-time":"2023-08-14T05:11:35Z","timestamp":1691989895000},"page":"1011-1019","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Emollients for preventing atopic eczema: Cost\u2010effectiveness analysis of the <scp>BEEP<\/scp> trial"],"prefix":"10.1111","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8098-9220","authenticated-orcid":false,"given":"Tracey H.","family":"Sach","sequence":"first","affiliation":[{"name":"Health Economics Group, Norwich Medical School University of East Anglia  Norwich UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stella T.","family":"Lartey","sequence":"additional","affiliation":[{"name":"Health Economics Group, Norwich Medical School University of East Anglia  Norwich UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Davies","sequence":"additional","affiliation":[{"name":"Norfolk and Norwich University Hospitals NHS Foundation Trust  Norwich UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne R.","family":"Chalmers","sequence":"additional","affiliation":[{"name":"Centre of Evidence Based Dermatology, School of Medicine University of Nottingham  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel H.","family":"Haines","sequence":"additional","affiliation":[{"name":"Nottingham Clinical Trials Unit University of Nottingham  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy E.","family":"Bradshaw","sequence":"additional","affiliation":[{"name":"Nottingham Clinical Trials Unit University of Nottingham  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan A.","family":"Montgomery","sequence":"additional","affiliation":[{"name":"Nottingham Clinical Trials Unit University of Nottingham  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim S.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Centre of Evidence Based Dermatology, School of Medicine University of Nottingham  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3232-5251","authenticated-orcid":false,"given":"Sara J.","family":"Brown","sequence":"additional","affiliation":[{"name":"Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer University of Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7954-8823","authenticated-orcid":false,"given":"Matthew J.","family":"Ridd","sequence":"additional","affiliation":[{"name":"Population Health Sciences University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Lawton","sequence":"additional","affiliation":[{"name":"Rotherham NHS Foundation Trust  Rotherham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mike J.","family":"Cork","sequence":"additional","affiliation":[{"name":"Sheffield Dermatology Research, Department of Infection and Immunity University of Sheffield  Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4884-6286","authenticated-orcid":false,"given":"Carsten","family":"Flohr","sequence":"additional","affiliation":[{"name":"Unit for Population\u2010Based Dermatology Research St John's Institute of Dermatology, Guy's &amp; 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