Colombo Giorgio L, Di Matteo Sergio, Bruno Giacomo, Girolomoni Giampiero, Vena Gino Antonio
University of Pavia, Department of Drug Sciences, School of Pharmacy, Pavia, Italy ; S.A.V.E. Studi Analisi Valutazioni Economiche, Milan, Italy.
Clinicoecon Outcomes Res. 2012;4:261-8. doi: 10.2147/CEOR.S35046. Epub 2012 Sep 13.
Psoriasis is a chronic inflammatory skin disease with a major impact on the quality of life of affected individuals. Topical therapy has an important role in the treatment of psoriasis. Poor treatment outcomes from topical therapy regimens likely result from poor adherence and ineffective use of medication.
A cost-minimization analysis was performed with the purpose of assessing the use of a gel containing calcipotriol and betamethasone dipropionate (Dovobet(®) gel) versus the ointment formulation (Dovobet ointment) in the treatment of psoriasis. The analysis was carried out using a Markov model with a one-year time horizon in a hypothetical cohort of patients with a Psoriasis Area and Severity Index score < 10. The model simulates different therapy adherence scenarios for the two different formulations.
The Dovobet gel strategy allows a 5% reduction in the number of patients who could potentially be treated with more expensive therapies (biologics and conventional systemic drugs) in comparison with the Dovobet ointment strategy, with a consequent impact on costs for the National Healthcare Service. The total annual cost of Dovobet gel is about €407.00 per patient, ie, 19% less that the total cost of about €500.00 of the Dovobet ointment strategy. The base case results were then examined by sensitivity analysis and budget impact analysis to correlate the various scenarios of Dovobet gel use with cost savings to the National Healthcare Service.
The Dovobet gel strategy seems more acceptable to patients, shows better overall adherence, and appears to be favorable from the pharmacoeconomic point of view than the ointment formulation for treatment of patients with mild-to-moderate psoriasis.
银屑病是一种慢性炎症性皮肤病，对患者的生活质量有重大影响。局部治疗在银屑病治疗中起着重要作用。局部治疗方案效果不佳可能是由于依从性差和用药不当所致。
进行了一项成本最小化分析，目的是评估使用卡泊三醇倍他米松二丙酸酯凝胶（达力士凝胶）与软膏制剂（达力士软膏）治疗银屑病的情况。分析采用马尔可夫模型，以一年为时间跨度，针对银屑病面积和严重程度指数评分<10的假设患者队列进行。该模型模拟了两种不同制剂的不同治疗依从性情况。
与达力士软膏策略相比，达力士凝胶策略可使可能需要使用更昂贵疗法（生物制剂和传统全身用药）治疗的患者数量减少5%，从而对国家医疗服务成本产生影响。达力士凝胶的年度总成本约为每位患者407.00欧元，即比达力士软膏策略约500.00欧元的总成本低19%。然后通过敏感性分析和预算影响分析对基础病例结果进行了研究，以将达力士凝胶使用的各种情况与国家医疗服务节省的成本相关联。
对于轻度至中度银屑病患者的治疗，从患者接受度来看，达力士凝胶策略似乎更易被接受，总体依从性更好，并且从药物经济学角度来看，似乎比软膏制剂更具优势。
