Cost-effectiveness analysis of a psoriasis care instruction programme with dithranol compared with UVB phototherapy and inpatient dithranol treatment.

Type:Uv phototherapy   Time:2017-09-28 9:07:23
Cost-effectiveness analysis of a psoriasis care instruction programme with dithranol compared with UVB phototherapy 
and inpatient dithranol treatment.
Hartman M1, Prins M, Swinkels OQ, Severens JL, De Boo T, Van Der Wilt GJ, Van De Kerkhof PC, Van Der Valk PG.
Author information
Abstract
BACKGROUND:
This study was part of a large national cost-effectiveness analysis, and was funded by the National Fund for 
Investigational Medicine of the Health Care Insurance Board.
OBJECTIVE:
To compare the costs of treatment of moderate to severe psoriasis by dithranol short contact therapy in a care 
instruction programme (short contact therapy) with ultraviolet B phototherapy (UVB) and inpatient dithranol treatment 
(inpatient treatment), and relate these costs to treatment effectiveness.
METHODS:
An open randomized controlled multicentre study was performed. The costs (both medical and non-medical) were 
calculated for the following periods: during treatment, per month during remission, after a relapse, and following an 
unsuccessful treatment. The effectiveness measures were the clinical response rate and the number of clearance days 
during follow-up.
RESULTS:
The data from 216 patients were analysed. The mean overall costs per patient during treatment were euro;1641, 
euro;1258 and euro;7706 for short contact treatment, UVB and inpatient treatment, respectively. During the clearance 
period the mean costs per month per patient were euro;19, euro;5 and euro;25, respectively. The clinical response 
rates were 57%, 57% and 85%, respectively. The mean number of clearance-days after short contact treatment was 160 
[median 119; interquartile range (0-357)], which was not significantly different from the other two strategies: 211 
clearance-days after inpatient treatment [241 (99-350)] and 136 clearance-days after UVB [81 (0-266)].
CONCLUSIONS:
Short contact treatment is an attractive alternative for patients with moderate to severe psoriasis currently treated 
by inpatient treatment, as the costs of short contact treatment were significantly lower and the number of clearance 
days was comparable. Considering the higher costs, short contact treatment is not a first choice treatment when 
compared with UVB.
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