Management of Pediatric Atopic Dermatitis by Primary Care Providers: A Systematic Review

Reducing costs in atopic dermatitis

“…Patient education is not limited to dermatological specialists, however. Pediatricians have an important role in identifying at‐risk patients, educating patients on the prevention and treatment of AD, managing treatments, and referring to dermatologists as needed for specialized care 16 …”

“…In patients with moderate-to-severe disease, treatment options include phototherapy, methotrexate, cyclosporine, dupilumab, and oral JAK inhibitors, such as abrocitinib and upadacitinib. 8,15,16,[50][51][52] These options vary widely in convenience of treatment and price (Figure 2). Office-based phototherapy is an effective treatment for AD, however it is limited by cost and requires multiple patient clinic visits per week.…”

“…64 Other treatment options for moderate-to-severe AD include methotrexate and cyclosporine. 15,16 For AD, cyclosporine is often prescribed at a dose of 3-5 mg/kg/day, and methotrexate is often prescribed at a dose of 7.5-15 mg/week. 67,68 Of the two, methotrexate is much less costly (Table 2) but may be less effective than cyclosporine, with patients on 15 mg/week of methotrexate improving less than patients on cyclosporine 2.5 mg/kg/day, over 2 months of treatment.…”

“…Alternatively, starting with the least costly approaches and using expensive medications only when needed may be preferable if cost containment is a priority. For example, when treating patients with moderate‐to‐severe AD, methotrexate may not be the most effective option, however, its affordability may make it a feasible option for patients when cost is a barrier to other treatments 15,16 . Overall, treatment plans need to be individualized based on the patients' individual needs.…”

“…For example, when treating patients with moderate-to-severe AD, methotrexate may not be the most effective option, however, its affordability may make it a feasible option for patients when cost is a barrier to other treatments. 15,16 Overall, treatment plans need to be individualized based on the patients' individual needs. The objective of this manuscript is to discuss the treatment and management of AD from a cost-conscious perspective.…”