title: Cost-effectiveness of a fixed combination of hydroquinone/tretinoin/fluocinolone cream compared with hydroquinone alone in the treatment of melasma.
abstract: 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.
authors: University of Rio Grande do Sul, Porto Alegre, Brazil.
authors: Tania
authors: T
authors: Cestari
authors: Lucie
authors: L
authors: Adjadj
authors: Margaret
authors: M
authors: Hux
authors: Maria Regina
authors: MR
authors: Shimizu
authors: Vincent Pierre
authors: VP
authors: Rives
mesh_terms: 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
chemical_list: D004338:Drug Combinations; D006873:Hydroquinones; D005446:Fluocinolone Acetonide; D014212:Tretinoin; C035394:fluocinolone; C031927:hydroquinone