O01 The UK–Irish Atopic Eczema Systemic Therapy Register (A-STAR): a pilot descriptive analysis of healthcare resource use, costs and health-related quality of life in patients on systemic treatments for atopic eczema

Abstract Clinical management of moderate-to-severe atopic eczema (AE) is complex, involving the use of several therapies. Some novel systemic immunomodulatory medications are effective but costly, while conventional systemic therapies have lower costs but require frequent monitoring due to their safety profiles. Novel systemic therapies for AE have been assessed in randomized controlled trials, but their evidence is incomplete to inform real-world practice and value-for-money considerations. The UK–Irish Atopic Eczema Systemic Therapy Register (A-STAR) was established to address the need for real-world evidence and to capture comprehensive health economics data surrounding the use of systemic therapies to manage moderate-to-severe AE. The aim of the current study was to describe healthcare resource utilization and patient-reported health-related quality of life (HRQoL) in a cohort of patients from A-STAR during a 1-year follow-up period and to evaluate the quality of the data collected in a real-world setting. The A-STAR register is a multicentre prospective register recruiting paediatric (< 16 years old) and adult (≥ 16 years old) patients with AE initiating or switching to systemic immunomodulatory therapy. Healthcare resource utilization data including general practitioner (GP) visits, accident and emergency attendance, hospitalizations, specialist consultations and systemic therapy were collected and valuated using national average unit costs. EuroQol-5D was used to measure HRQoL. In total 120 A-STAR participants (92 adults and 28 children) with at least 1 year of follow-up were included in this pilot study. Adults showed higher healthcare utilization than children. For adults, the mean costs per visit included accident and emergency attendance (£120.41), GP appointments (£111.15) and outpatient specialist visits (£205.17). Children had lower healthcare utilization and costs per visit: accident and emergency attendance (£84.29), GP appointments (£78.46) and outpatient specialist visits (£121.00). All participants required outpatient dermatology visits, with a mean cost of £551 for adults and £777 for children. Both groups received systemic therapy, and adults incurred higher costs (mean £25 523, SD £24 424) than children (mean £20 242, SD £18 994). The average EuroQol-5D scores improved in both groups from baseline to 1 year, from 0.61 (SD 0.31) to 0.77 (SD 0.24) in adults, and from 0.48 (SD 0.37) to 0.75 (SD 0.27) in children. In this pilot descriptive analysis, patients with AE receiving systemic treatment were found to accrue substantial healthcare resource use and tended to have an improvement in their HRQoL within the observed period. Registers like A-STAR hold promise in health research, aiding policymakers in formulating treatment pathways for patients and optimizing sparse data to enhance overall outcomes. These insights are crucial for shaping future register data collection efforts and advancing healthcare decision making, including by the UK National Institute for Clinical and Care Excellence.