A Cost-utility Analysis of Calcipotriol/Betamethasone Dipropionate Aerosol Foam versus Ointment for the Topical Treatment of Psoriasis Vulgaris in Sweden
Albert Duvetorp, Lars-Åke Levin, Emma Engerstedt Mattsson, Lasse Ryttig
Psoriasis is a chronic inflammatory disorder that imposes a substantial economic burden. We conducted a cost-utility analysis from a Swedish healthcare payers perspective using a decision-tree model with a 12-week time horizon. Patients with psoriasis vulgaris could have two 4-week cycles of topical treatment with calcipotriol 50 µg/g and betamethasone 0.5 mg/g as dipropionate (Cal/BD) foam or Cal/BD ointment before progressing to phototherapy/methotrexate. In the base-case analysis, Cal/BD foam dominated over Cal/BD ointment. The increased efficacy of Cal/BD foam resulted in fewer consultations and a decreased risk of progressing to phototherapy/methotrexate. Although Cal/BD foam costs more than Cal/BD ointment, this was offset by lower costs for phototherapy/methotrexate or consultation visits. Sensitivity analyses revealed that the base-case net monetary benefit was robust to plausible variations in key parameters. In conclusion, Cal/BD foam was predicted to be more cost-effective than Cal/BD ointment in the treatment of psoriasis vulgaris.
Psoriasis is a chronic heterogenous disorder with a substantial impact on patients and healthcare systems. We evaluated the cost-effectiveness of Cal/BD foam versus Cal/BD ointment over a 12-week time horizon in patients with psoriasis, from a Swedish healthcare perspective. In our model, the superior efficacy of Cal/BD foam over ointment led to fewer consultation visits, a decreased risk of progressing to second-line therapy, and lower total costs. Improved topical therapies, such as Cal/BD foam, have the potential to reduce the need for some patients to progress to phototherapy and/or systemic treatment, which may lead to a reduction in the overall treatment costs of psoriasis.