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钙泊三醇/倍他米松二丙酸酯气雾剂与软膏治疗瑞典寻常型银屑病的成本-效用分析。

A Cost-utility Analysis of Calcipotriol/Betamethasone Dipropionate Aerosol Foam versus Ointment for the Topical Treatment of Psoriasis Vulgaris in Sweden.

机构信息

Division of Dermatology and Venereology, Skåne University Hospital, Malmö, Sweden.

出版信息

Acta Derm Venereol. 2019 Apr 1;99(4):393-399. doi: 10.2340/00015555-3112.

Abstract

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.

摘要

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。

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