Masaki Saori, Tatsukawa Ryoko, Uryu Miki, Takahara Masakazu, Furue Masutaka, Ohata Chika, Nakama Takekuni, Hino Ryosuke, Nakamura Motonobu, Nakayama Juichiro, Imafuku Shinichi
Department of Dermatology, Fukuoka University, Fukuoka, Japan.
Department of Dermatology, Kyusyu University, Fukuoka, Japan.
J Dermatol. 2017 Feb;44(2):143-146. doi: 10.1111/1346-8138.13541. Epub 2016 Sep 7.
There is a range of psoriasis treatments available, from topical applications to biologic therapy, with corresponding cost variations. The efficacy of each treatment is usually evaluated by objective measures such as the Psoriasis Area and Severity Index (PASI) or subjective measures such as the Dermatology Life Quality Index (DLQI). However, the social and economic impacts of psoriasis, including cost-effectiveness, have not been assessed in Japan. The EuroQol 5-Dimension (EQ-5D) is a generic instrument used worldwide to calculate quality-adjusted life years, on which calculations of treatment cost-effectiveness are based. We conducted a pilot study to determine the cost-effectiveness of psoriasis treatment in Japan. We administered a questionnaire to 133 patients with psoriasis (105 men and 28 women) who visited four university hospitals in Fukuoka Prefecture. The questionnaire covered medical costs, satisfaction and willingness to pay (WTP), and we investigated the relationships between these items. PASI was evaluated by physicians. More participants indicated satisfaction with treatment in the group paying less than ¥5000/month. WTP, PASI and EQ-5D showed little correlation. However, the DLQI and EQ-5D showed a moderate correlation (r = 0.472). WTP seemed more dependent on participants' economic backgrounds. We found that it was difficult to reflect the PASI with the EQ-5D. However, the DLQI may be used to estimate the cost-benefit relationship in patients with psoriasis. This is the first study to evaluate the EQ-5D in patients with psoriasis in Japan.
目前有一系列治疗银屑病的方法，从局部用药到生物疗法，费用各不相同。每种治疗方法的疗效通常通过客观指标如银屑病面积和严重程度指数（PASI）或主观指标如皮肤病生活质量指数（DLQI）来评估。然而，银屑病的社会和经济影响，包括成本效益，在日本尚未得到评估。欧洲五维健康量表（EQ-5D）是一种在全球范围内用于计算质量调整生命年的通用工具，治疗成本效益的计算基于该量表。我们进行了一项试点研究，以确定日本银屑病治疗的成本效益。我们对133名银屑病患者（105名男性和28名女性）进行了问卷调查，这些患者前往福冈县的四家大学医院就诊。问卷涵盖医疗费用、满意度和支付意愿（WTP），我们研究了这些项目之间的关系。PASI由医生评估。更多参与者表示对每月支付低于5000日元的治疗组感到满意。WTP、PASI和EQ-5D之间几乎没有相关性。然而，DLQI和EQ-5D显示出中等程度的相关性（r = 0.472）。WTP似乎更多地取决于参与者的经济背景。我们发现很难用EQ-5D反映PASI。然而，DLQI可用于估计银屑病患者的成本效益关系。这是日本第一项评估银屑病患者EQ-5D的研究。
