Cost-effectiveness of once-daily treatment with calcipotriol/betamethasone dipropionate followed by calcipotriol alone compared with tacalcitol in the treatment of Psoriasis vulgaris.
BACKGROUND
Daivobet is a once-daily treatment of psoriasis vulgaris containing betamethasone dipropionate and calcipotriol in a new ointment vehicle.


OBJECTIVE
To assess the cost-effectiveness of once-daily treatment with Daivobet (4 weeks) followed by calcipotriol (4 weeks) compared to tacalcitol (8 weeks).


METHODS
Resource utilization was assessed within a double-blind 8-week clinical trial (all treatments for psoriasis, adverse events and concomitant dermatological medication), estimated from the French societal perspective.


RESULTS
Total direct medical costs for psoriasis were comparable (Daivobet: EUR 107.53 and tacalcitol EUR 113.50) despite a higher acquisition cost for Daivobet. The probability of > or =75% reduction in the Psoriasis Area and Severity Index (effectiveness criterion) was 46.6% with Daivobet and 13.9% with tacalcitol at 4 weeks, and 44.6 and 23.8%, respectively, at 8 weeks (both: p < 0.001). Over 8 weeks, Daivobet was almost twice as cost-effective as tacalcitol (EUR 241.22 per successful treatment vs. EUR 476.70); this result was robust to sensitivity assumptions.


CONCLUSIONS
Daivobet is more effective and less costly than tacalcitol for treating psoriasis.
Peeters
Pascale
P
Quintiles Analytics France, Levallois-Perret, France. pascale.peeters@quintiles.com
Ortonne
Jean-Paul
JP
Sitbon
René
R
Guignard
Eric
E
D000287:Administration, Topical; D000328:Adult; D000368:Aged; D001623:Betamethasone / Q000008:administration & dosage / Q000031:analogs & derivatives*; D002117:Calcitriol / Q000008:administration & dosage / Q000031:analogs & derivatives*; D016001:Confidence Intervals; D003362:Cost-Benefit Analysis; D004100:Dihydroxycholecalciferols / Q000008:administration & dosage* / Q000191:economics*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004338:Drug Combinations; D016527:Drug Costs; D005060:Europe; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009824:Ointments; D011336:Probability; D011565:Psoriasis / Q000175:diagnosis / Q000188:drug therapy*; D012016:Reference Values; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome
D004100:Dihydroxycholecalciferols; D004338:Drug Combinations; D009824:Ointments; C055085:calcipotriene; C023850:1 alpha,24-dihydroxyvitamin D3; C011175:betamethasone-17,21-dipropionate; D001623:Betamethasone; D002117:Calcitriol