An effective personal supporting intervention for topical treatment is also cost-effective for psoriasis
Mathias Tiedemann Svendsen, Klaus Ejner Andersen, Steven R Feldman, Anna Mejldal, Sören Möller, Line Planck Kongstad- Dermatology
Abstract
Background
Topical treatment combined with regular patient-support provided by dermatological nurses in structured consultations of 20-minuts duration every fourth weeks improved psoriasis severity, quality of life, and treatment adherence compared to topical treatment combined with standard patient-support which is seeing a dermatologist every third month.
Aim
To examine economic impact of the patient support from a healthcare sector perspective.
Methods
Costs for primary care, secondary healthcare services, and costs of prescription medication were compared for the intervention and non-intervention group over 48 weeks. Health benefits were expressed in terms of quality-adjusted life-years (QALYs) measured by the EuroQoL five-dimension three-level questionnaire. Regression analyses were used to estimate incremental cost and QALYs.
Results
The incremental cost was estimated at £462, with an average increase of 0.08 QALYs per patients for patients receiving the intervention compared to patients receiving standard care. The incremental cost-effectiveness ratio for patients was £5,999/QALY. The intervention had an almost 100% probability of being cost-effective at a willingness-to-pay threshold of £30,000 per QALY.
Conclusion
Addressing adherence issues is critical to improving psoriasis patients’ topical treatment outcomes. The personal support intervention was effective with an acceptable increase in costs.