Cost-Effectiveness Analysis Comparing Methotrexate With PUVA Therapy for Moderate—Severe Psoriasis in the Sanitary Area of Badajoz

Autor: A. Chaves, D. de Argila, Isabel Rodríguez-Nevado
Rok vydání: 2007
Předmět:
Zdroj: Actas Dermo-Sifiliográficas (English Edition). 98:35-41
ISSN: 1578-2190
DOI: 10.1016/s1578-2190(07)70387-6
Popis: Objective To perform a cost-effectiveness analysis, by using a decision tree model, comparing methotrexate with PUVA therapy for moderate to severe chronic plaque psoriasis in the sanitary area of Badajoz (south-western Spain) over a one-year period. Material and methods The following variables and data sources were included: efficacy (a 50% reduction in the PASI) and safety. Data were retrieved from the dermatologic medical literature, mainly general reviews, systematic reviews and randomized clinical trials. Therapy schedules followed current guidelines from work task teams and consensus documents. Direct costs included unitary costs of medical consults, costs of laboratory tests, pharmacy, phototherapy sessions and costs derived from adverse reactions. Indirect costs included travel expenses and costs of lost productive work time. Results Unitary cost of methotrexate therapy would be 952,79 euros per treatment (direct cost: 796,48; indirect cost: 156,31). Unitary cost of PUVA therapy would be 899,70 euros per treatment (direct cost: 383,36; indirect cost: 516,34). Total cost of a one-year treatment with methotrexate would be 255,202.73 euros. Total cost of a one-year treatment with PUVA would be 266,406.88 euros. The average cost-effectiveness ratios per case successfully treated would be 1,519.06 euros for methotrexate therapy, and 1,085.18euros for PUVA therapy. The incremental cost-effectiveness ratio of PUVA/methotrexate would be 150,65euros for each additional case successfully treated. Conclusions One-year treatment for moderate to severe psoriasis in the sanitary area of Badajoz would be more expensive but also more cost-effective with PUVA than with methotrexate. However, indirect costs (borne by patients in the Spanish Health System), are higher for PUVA therapy, a fact that raises an issue of equity. The results should be interpreted taking into account the methodological limitations of a modelling study.
Databáze: OpenAIRE
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