What is the cost of atopic dermatitis in preschool children?

Background Atopic dermatitis (AD) is the most common inflammatory skin diso rder and an important cause of morbidity in young children in the U.K. Such disability produces significant economic burden reflected in direct medica l costs associated with health service utilization, direct family care cost s such as transport costs, indirect costs associated with loss of productiv ity of carers, and intangible costs associated with the psychological effec ts of the disease. Objectives In order to evaluate this economic burden we conducted a cross-s ectional survey of children aged 1-5 years in the Nottingham area in 1995-9 6, Methods We sent a postal questionnaire to parents of all children aged 1-5 years with questions to identify those with AD; a second questionnaire was sent to parents of identified children regarding costs and utilization of m edical services. Intangible costs were not evaluated. Results The 12-month period prevalence of AD according to a dermatologist's diagnosis in 1761 children was 16.5% (95% confidence interval 14.7-18.2%). Total mean disease costs were estimated to be pound 79.59 per child over t he 12-month period of the study. The most significant costs were due to cos ts to the state for National Health Service (NHS) consultations (pound 28.6 2 mean annual cost) and prescriptions (pound 22.03). Consultations with gen eral practitioners accounted for the significant bulk of consultation costs , with only 6% of children being seen in secondary care (17 of 290). Most p rescribing costs (76%) were due to emollients and bath preparations. Family care costs (pound 28.94 mean annual cost) accounted for 36% of total disea se costs and were associated with changes to the home environment, purchase of over-the-counter medicines, transport costs, visits to homoeopaths and salary loss. Conclusions The results signify that AD is an important cause of economic, burden both to the NHS and to the families of affected children. Using popu lation census data and the results in this study, we estimated that the ann ual U.K. cost of AD in children aged 1-5 years in 1995-96 was pound 47 mill ion.