MindMySkin Economic Evaluation Protocol
The study is designed to test whether MindMySkin offers economic value versus an active general-wellness app, but it is a protocol and does not yet provide completed comparative clinical or economic results.
This briefing covers a planned trial-based economic evaluation of MindMySkin, a digital psychobehavioral mobile intervention for people with psoriasis, eczema, or chronic urticaria in Singapore. The central question is whether the intervention can represent value for money when compared with Healthy365, an active general-wellness app, from the health care system perspective. [pmid:42809473]
Evidence
The reported design is a multicenter, double-blind randomized controlled trial with a trial-based economic evaluation conducted as a secondary analysis. The target population is English-speaking people with psoriasis, eczema, or chronic urticaria recruited through outpatient dermatology settings in Singapore. The planned sample size is 690 participants. [pmid:42809473]
Participants are assigned in a 2:1 ratio to MindMySkin or Healthy365 and followed for 32 weeks. Healthy365 is described as a Singapore Health Promotion Board general-wellness app offering health tracking, fitness challenges, and lifestyle recommendations, without a specific focus on skin disease or psychodermatological outcomes. [pmid:42809473]
MindMySkin is intended to address psychobehavioral determinants of symptom burden in chronic inflammatory skin disease. Its modules target illness coherence, symptom management, and emotional and functional impairment. These intervention aims describe the rationale for evaluation; they are not evidence of benefit in the population under study. [pmid:42809473]
The primary economic viewpoint is the health care system perspective. Planned cost inputs include intervention deployment and dermatology-related health care use. A societal-perspective sensitivity analysis is planned to include indirect medical costs and work-productivity losses. [pmid:42809473]
For cost-effectiveness analysis, the protocol specifies the Dermatology Life Quality Index as the dermatology-specific outcome measure. For cost-utility analysis, it specifies deriving health utilities from the EQ-5D-5L to estimate quality-adjusted life years. The planned statistical approach uses intention-to-treat analyses with regression adjustment to estimate incremental cost-effectiveness ratios and net monetary benefit. [pmid:42809473]
The protocol also prespecifies uncertainty work through bootstrapping, deterministic sensitivity analyses, subgroup analyses, and scenario modeling. A five-year Markov-model extrapolation is conditional: it will be undertaken if within-trial results suggest a high likelihood of cost-effectiveness. [pmid:42809473]
Analysis — Decision relevance
This is a value-assessment protocol rather than a completed effectiveness or cost-effectiveness report. Accordingly, it establishes a comparator, analytic perspectives, outcome instruments, and methods for handling uncertainty, but it does not establish that MindMySkin improves quality of life, lowers costs, or is cost-effective relative to Healthy365. No completed comparative effect estimate, confidence interval, or p-value is reported here. [pmid:42809473]
The active-app comparator is important for interpretation because the planned comparison is not simply against no digital support. The economic analysis is positioned to assess incremental value of a skin-focused psychobehavioral intervention against a general wellness application. Whether any observed difference would be large enough to matter clinically, economically, or for implementation will depend on completed trial results and the resulting uncertainty estimates. Statistical significance, if later reported, would not by itself establish clinical significance. [pmid:42809473]
The choice to pair a dermatology-specific quality-of-life measure with EQ-5D-5L-derived utilities gives the planned evaluation two related but distinct outcome lenses: condition-relevant quality of life and health utility for cost-utility analysis. This can make the eventual economic case more informative, but the protocol does not yet show how either measure will differ between groups. [pmid:42809473]
The study reported that recruitment had begun and that participants had been enrolled, while economic analysis was expected after trial completion. That operational status reinforces that the present evidence should be read as a prespecified plan, not as an outcome report. [pmid:42809473]
Limitations
The protocol identifies self-reported health care use for cost estimation as a potential source of recall bias because comprehensive financial data or national benchmarks are unavailable. This may affect the precision or validity of estimated resource use and costs. [pmid:42809473]
The follow-up horizon limits assessment of longer-term costs and outcomes. Although the protocol contemplates conditional model-based extrapolation, extrapolated conclusions would rely on assumptions beyond the within-trial observation period. [pmid:42809473]
The authors also note that effectiveness estimated in a controlled trial may overestimate effectiveness under routine implementation if engagement and adherence are higher in the trial. Restriction to English-speaking participants may introduce selection bias and limit generalizability to the broader Singapore population with chronic inflammatory skin diseases. [pmid:42809473]