Cost-effectiveness evaluation of clobetasol propionate shampoo (CPS) maintenance in patients with moderate scalp psoriasis: a Pan-European analysis.
BACKGROUND
Scalp psoriasis is a difficult to treat and usually chronic manifestation of psoriasis. The CalePso study showed that CPS (Clobex(®) Shampoo) in maintenance therapy of scalp psoriasis (twice weekly) significantly increases the probability of keeping patient under remission during 6 months, compared with vehicle (40.3% relapses vs. 11.6% relapses, ITT).


OBJECTIVE
The objective of the study was to assess the cost-effectiveness of a maintenance therapy with CPS vs. its vehicle in nine European countries.


METHODS
A 24-week decision tree model was developed with 4-weekly time steps. The considered population has moderate scalp psoriasis successfully treated with a daily application of CPS up to 4 weeks. Data were taken from the CalePso study and from national experts' recommendations for alternative treatment choices, with their probabilities of success taken from literature to develop country-specific models. Health benefits are measured in disease-free days (DFD). The economic analysis includes drug and physician costs. A probabilistic sensitivity analysis (PrSA) assesses the uncertainty of the model.


RESULTS
Depending on the country, the mean total number of DFDs per patient is 21-42% higher with CPS compared with vehicle, and the mean total cost is 11-31% lower. The mean costs per DFD are 30-46% lower with CPS compared with the vehicle. The PrSA showed in 1000 simulations that CPS is more effective vs. vehicle in 100% of the cases and less expensive than its vehicle in 80-99% of the cases.


CONCLUSIONS
This model suggests that CPS is cost-effective in maintaining the success achieved in moderate scalp psoriasis patients.
K. Papp Clinical Research Inc., Waterloo, Ontario, Canada.
K
K
Papp
Y
Y
Poulin
K
K
Barber
C
C
Lynde
J C
JC
Prinz
M
M
Berg
N
N
Kerrouche
V P
VP
Rives
D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000191:economics / Q000627:therapeutic use; D002990:Clobetasol / Q000008:administration & dosage* / Q000191:economics / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D005060:Europe; D006203:Hair Preparations; D006801:Humans; D011565:Psoriasis / Q000188:drug therapy*; D012535:Scalp
D000893:Anti-Inflammatory Agents; D006203:Hair Preparations; D002990:Clobetasol