title: An economic evaluation of intermittent cyclosporin A therapy versus UVAB phototherapy in the treatment of patients with severe atopic dermatitis.
abstract: We performed a cost-effective evaluation of cyclosporin A versus UVAB phototherapy in the treatment of severe atopic dermatitis. The analysis was based on a one-year open prospective clinical trial conducted in Finland and showed that patients who received intermittent cyclosporin A therapy had on average 191 remission days per year, i.e. where disease activity was reduced by 50% or more. Patients receiving UVAB phototherapy had on average 123 remission days per year. All costs were estimated for the one-year period. Health service utilization of the 2 treatment groups was estimated based on the data gathered during the clinical study. Total costs were USD 5,438 in the cyclosporin A group and USD 5,635 in the UVAB group. Direct health-care costs were USD 4,935 in the cyclosporin A group and USD 3,124 in the UVAB group. The cost of a remission day was USD 28 in the cyclosporin A group and USD 46 in the UVAB group. In terms of direct health-care costs, the cost of a remission day was USD 26 in the cyclosporin A group and USD 25 in the UVAB group. Our results demonstrate that cyclosporin A therapy is similarly cost-effective as UVAB phototherapy in terms of total cost in the treatment of atopic dermatitis unresponsive to topical treatment. In terms of direct health-care costs, i.e. treatment and health services utilization costs, however, UVAB is significantly less costly, but side effects are frequent.
authors.affiliation: National Public Health Institute, Department of Vaccines, Helsinki, Finland. heini.salo@ktl.fi
authors.forename: Heini
authors.initials: H
authors.lastname: Salo
authors.forename: Markku
authors.initials: M
authors.lastname: Pekurinen
authors.forename: Håkan
authors.initials: H
authors.lastname: Granlund
authors.forename: Marja
authors.initials: M
authors.lastname: Nuutinen
authors.forename: Pekka
authors.initials: P
authors.lastname: Erkko
authors.forename: Sakari
authors.initials: S
authors.lastname: Reitamo
mesh_terms: D000328:Adult; D000368:Aged; D016001:Confidence Intervals; D017046:Cost Savings; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D016572:Cyclosporine / Q000191:economics* / Q000627:therapeutic use; D003695:Delivery of Health Care / Q000191:economics / Q000706:statistics & numerical data; D003876:Dermatitis, Atopic / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics / Q000532:radiotherapy*; D005260:Female; D005387:Finland; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D011336:Probability; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014467:Ultraviolet Therapy / Q000191:economics* / Q000379:methods; D014481:United States
chemical_list: D016572:Cyclosporine