Cost-effectiveness model of topical treatment of mild to moderate psoriasis vulgaris in Germany. A comparison of calcipotriol/betamethasone (Daivobet/Dovobet/Taclonex) once daily and a morning/evening non-fix combination of calcipotriol and betamethasone.
BACKGROUND
Psoriasis vulgaris requires lifelong treatment associated with considerable health cost. Studies showed that a combination of a steroid and a vitamin D(3) analogue is more effective than both compounds in monotherapy.


OBJECTIVE
To determine the cost-effectiveness of a fix calcipotriol/betamethasone combination (Daivobet/Dovobet/Taclonex) compared to a morning/evening non-fix calcipotriol/betamethasone combination in psoriasis treatment.


METHODS
A Markov model (discrete-time stochastic process based on transitions between health states) with 2 treatment arms (Daivobet/Dovobet/Taclonex vs. non-fix calcipotriol/betamethasone) over a 48-week time period was developed. The effectiveness criterion was the number of days with clearance or marked improvement. Clinical and health resource utilisation data were derived from randomised studies.


RESULTS
Treatment with Daivobet/Dovobet/Taclonex showed a higher cost-effectiveness compared to the non-fix combination, even when assuming a maximum compliance for the twice daily non-fix combination and varying the effectiveness of Daivobet/Dovobet/Taclonex by 10%.


CONCLUSIONS
Psoriasis treatment with a fix calcipotriol/betamethasone combination is more cost-effective than a non-fix morning/evening combination.
Augustin
M
M
Klinik und Poliklinik fur Dermatologie und Venerologie, Universitatsklinikum Hamburg-Eppendorf, Hamburg, Germany. m.augustin@derma.de
Peeters
P
P
Radtke
M
M
Moehling
U
U
Lapp
C
C
D000287:Administration, Topical; D000328:Adult; D000368:Aged; D001623:Betamethasone / Q000008:administration & dosage* / Q000031:analogs & derivatives* / Q000191:economics; D002117:Calcitriol / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000191:economics; D003362:Cost-Benefit Analysis; D003879:Dermatologic Agents / Q000008:administration & dosage* / Q000191:economics; D004334:Drug Administration Schedule; D004338:Drug Combinations; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D018803:Models, Economic; D008962:Models, Theoretical; D011565:Psoriasis / Q000188:drug therapy*