title: Per-gram cost of medication is by itself a poor indicator for comparing costs of different psoriasis treatments: a retrospective cohort study of the cost of psoriasis treatment with topical corticosteroids versus topical calcipotriene.
abstract: BACKGROUND
  New treatments are available for psoriasis that complement or replace the use of topical corticosteroids.
  
  
  OBJECTIVE
  The purpose of this article is to assess the relative overall cost difference between regimens based on topical steroids and those using the nonsteroidal anti- psoriasis medication, topical calcipotriene.
  
  
  METHODS
  Retrospective data on the cost of therapy of psoriasis were attained through analysis of claims from a national pharmaceutical-and-medical-visit claims-database. Episodes of psoriasis treatment were defined and analyzed for patients whose therapy was initiated with either topical calcipotriene or topical corticosteroids of different potency classes.
  
  
  RESULTS
  The average medication cost per episode was greater for topical calcipotriene ($111/episode) compared to ultra-high potency ($70/episode), high potency ($57/episode), mid potency ($47/episode), and low-potency, ($75/episode) topical corticosteroids (p <.05). The average total cost of therapy for the topical calcipotriene regimen ($218) fell within the range for the cost of therapy for topical steroid base regimens ($197 to $457); there were no significant differences in the total cost of therapy between topical calcipotriene monotherapy and other treatment groups.
  
  
  CONCLUSIONS
  The per-gram cost of medication is by itself a poor indicator for comparing the cost of different psoriasis treatment regimens. Given the greater safety and efficacy of combination regimens in terms of both short-term improvement and long-term control, initiating psoriasis treatment with a combination regimen of topical calcipotriene combined with an ultrapotent corticosteroid appears to be the most cost-effective approach to psoriasis treatment.
authors.affiliation: Wake Forest University School of Medicine, Plainsboro, New Jersey, USA.
authors.forename: S R
authors.initials: SR
authors.lastname: Feldman
authors.forename: S
authors.initials: S
authors.lastname: Sahu
authors.forename: A B
authors.initials: AB
authors.lastname: Fleischer
authors.forename: C M
authors.initials: CM
authors.lastname: Dezii
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000191:economics* / Q000627:therapeutic use; D002117:Calcitriol / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000191:economics* / Q000627:therapeutic use; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D016527:Drug Costs / Q000706:statistics & numerical data; D017850:Economics, Pharmaceutical; D005260:Female; D005938:Glucocorticoids; D006801:Humans; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy / Q000191:economics*; D012189:Retrospective Studies
chemical_list: D000893:Anti-Inflammatory Agents; D003879:Dermatologic Agents; D005938:Glucocorticoids; C055085:calcipotriene; D002117:Calcitriol