Division of Dermatology and Venereology, Skåne University Hospital, Malmö, Sweden.
Acta Derm Venereol. 2019 Apr 1;99(4):393-399. doi: 10.2340/00015555-3112.
Psoriasis is a chronic inflammatory disorder that imposes a substantial economic burden. We conducted a cost-utility analysis from a Swedish healthcare payers perspective using a decision-tree model with a 12-week time horizon. Patients with psoriasis vulgaris could have two 4-week cycles of topical treatment with calcipotriol 50 µg/g and betamethasone 0.5 mg/g as dipropionate (Cal/BD) foam or Cal/BD ointment before progressing to phototherapy/methotrexate. In the base-case analysis, Cal/BD foam dominated over Cal/BD ointment. The increased efficacy of Cal/BD foam resulted in fewer consultations and a decreased risk of progressing to phototherapy/methotrexate. Although Cal/BD foam costs more than Cal/BD ointment, this was offset by lower costs for phototherapy/methotrexate or consultation visits. Sensitivity analyses revealed that the base-case net monetary benefit was robust to plausible variations in key parameters. In conclusion, Cal/BD foam was predicted to be more cost-effective than Cal/BD ointment in the treatment of psoriasis vulgaris.
银屑病是一种慢性炎症性疾病,会带来巨大的经济负担。我们从瑞典医疗保健支付者的角度,使用决策树模型,对 12 周的时间范围进行了成本-效用分析。患有寻常型银屑病的患者,在接受光疗/甲氨蝶呤治疗之前,可以选择两种治疗方案:卡泊三醇 50μg/g 和倍他米松 0.5mg/g 双丙酸盐(Cal/BD)泡沫剂或软膏,每个疗程 4 周,共两个疗程。在基本案例分析中,Cal/BD 泡沫剂优于 Cal/BD 软膏。Cal/BD 泡沫剂的疗效更高,导致就诊次数减少,进展为光疗/甲氨蝶呤的风险降低。尽管 Cal/BD 泡沫剂的成本高于 Cal/BD 软膏,但光疗/甲氨蝶呤或就诊费用的降低抵消了这一成本。敏感性分析表明,基本案例的净货币效益对关键参数的合理变化具有稳健性。总之,Cal/BD 泡沫剂在治疗寻常型银屑病方面比 Cal/BD 软膏更具成本效益。