OBJECTIVES: Payers sometimes allow the use of utility values from proxy conditions in cost-effectiveness models, if proven more appropriate. For conditions such as alopecia areata (AA) where generic preference-based measures often fail to capture the full burden of hrQoL to patients, this offers an alternative approach to reimbursement discussions. However, ensuring the correct proxy condition is used is critically important. This scoping review sought to select a suitable proxy condition for AA, by mapping key hrQoL domains and symptoms of importance as defined by patients with lived experience of the condition.

METHODS: A pragmatic electronic literature search was conducted in May 2023, via PubMed, Medline (Ovid platform) and Google Scholar using relevant key words related to AA, hrQoL and potential proxy diseases. Bidirectional snowballing searching via key publications ensured completeness.

Proxy health condition(s) were identified by demonstrating similarities between reported patient experience and symptoms and conceptual models to AA.

RESULTS: Six conditions overlapped in key domains (physical, emotional, psychological and relationship impacts, and stigmatisation) and symptoms of AA, including atopic dermatitis (6 domains), acne, chronic hand eczema and psoriatic arthritis (5 domains each), irritable bowel syndrome and psoriasis (4 domains each).

Additionally, 9 further conditions showed similarities to the lived experience of AA, but had no conceptual models identified in the literature, including vitiligo, urticaria, rosacea, cellulitis, and contact dermatitis.

CONCLUSIONS: This scoping review demonstrates a systematic and robust approach to identifying suitable proxy conditions for AA, by considering the impact of the disease on a patient’s lived experience. Successfully identifying proxy conditions, ensures that appropriate utility values can be sought and used in cost-effectiveness models for AA. Thus, enabling meaningful treatment-related benefit assessments and subsequent decision making by payers. Future research will focus on collating the range of utility values that exist for the chosen proxy condition.