Cost-effectiveness of a fixed combination of hydroquinone/tretinoin/fluocinolone cream compared with hydroquinone alone in the treatment of melasma.
BACKGROUND
A once-daily fixed combination of hydroquinone, tretinoin, and fluocinolone acetonide (Tri-luma) is a newly available treatment for melasma.


OBJECTIVE
To assess cost-effectiveness of triple combination therapy (TCT) applied once daily and hydroquinone alone applied twice daily in the U.S., Argentina, Brazil, Chile, and Colombia from a payer's perspective.


METHODS
Clinical data and utilization of key health resources (medication only) were assessed within an 8-week clinical trial conducted in Brazil. Total cost per primary success (complete clearing) was used to compare each treatment with not treating and incremental cost effectiveness ratios were used to compare between treatments.


CONCLUSIONS
TCT had a 30% better rate of complete clearing than hydroquinone with a lower cost in the U.S. and an incremental cost in other countries. In every country, cost per primary success was lower for TCT than for hydroquinone. Results were robust to varying assumptions of success rates and quantity used.
Cestari
Tania
T
University of Rio Grande do Sul, Porto Alegre, Brazil.
Adjadj
Lucie
L
Hux
Margaret
M
Shimizu
Maria Regina
MR
Rives
Vincent Pierre
VP
D000287:Administration, Topical; D003362:Cost-Benefit Analysis; D004338:Drug Combinations; D016527:Drug Costs; D005446:Fluocinolone Acetonide / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000191:economics; D006801:Humans; D006873:Hydroquinones / Q000008:administration & dosage* / Q000191:economics; D008548:Melanosis / Q000188:drug therapy* / Q000191:economics; D016896:Treatment Outcome; D014212:Tretinoin / Q000008:administration & dosage* / Q000191:economics
D004338:Drug Combinations; D006873:Hydroquinones; D005446:Fluocinolone Acetonide; D014212:Tretinoin; C035394:fluocinolone; C031927:hydroquinone