Calcipotriol and betamethasone dipropionate in the treatment of mild-to-moderate psoriasis: a cost-effectiveness analysis of the ointment versus gel formulation

Abstract

Giorgio L Colombo1,2 Sergio Di Matteo,2 Giacomo Bruno,2 Giampiero Girolomoni,3 Gino Antonio Vena41University of Pavia, Department of Drug Sciences, School of Pharmacy, Pavia, Italy; 2S.A.V.E. Studi Analisi Valutazioni Economiche, Milan, Italy; 3Sections of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy; 4Department of Biomedical Sciences and Human Oncology, Unit of Dermatology and Venereology University of Bari, Bari, ItalyBackground: Psoriasis is a chronic inflammatory skin disease with a major impact on the quality of life of affected individuals. Topical therapy has an important role in the treatment of psoriasis. Poor treatment outcomes from topical therapy regimens likely result from poor adherence and ineffective use of medication.Methods: A cost-minimization analysis was performed with the purpose of assessing the use of a gel containing calcipotriol and betamethasone dipropionate (Dovobet® gel) versus the ointment formulation (Dovobet ointment) in the treatment of psoriasis. The analysis was carried out using a Markov model with a one-year time horizon in a hypothetical cohort of patients with a Psoriasis Area and Severity Index score < 10. The model simulates different therapy adherence scenarios for the two different formulations.Results: The Dovobet gel strategy allows a 5% reduction in the number of patients who could potentially be treated with more expensive therapies (biologics and conventional systemic drugs) in comparison with the Dovobet ointment strategy, with a consequent impact on costs for the National Healthcare Service. The total annual cost of Dovobet gel is about €407.00 per patient, ie, 19% less that the total cost of about €500.00 of the Dovobet ointment strategy. The base case results were then examined by sensitivity analysis and budget impact analysis to correlate the various scenarios of Dovobet gel use with cost savings to the National Healthcare Service.Conclusion: The Dovobet gel strategy seems more acceptable to patients, shows better overall adherence, and appears to be favorable from the pharmacoeconomic point of view than the ointment formulation for treatment of patients with mild-to-moderate psoriasis.Keywords: pharmacoeconomics, cost-minimization, cost-consequences, psoriasis, calcipotriol and betamethasone dipropionate, patient adherence