Cost-effectiveness model of topical treatment of mild to moderate psoriasis vulgaris in Germany

Background: Psoriasis vulgaris requires lifelong treatment associated with considerable health cost. Studies showed that a combination of a steroid and a vitamin D-3 analogue is more effective than both compounds in monotherapy. Objective: To determine the cost-effectiveness of a fix calcipotriol/betamethasone combination (Daivobet (R)/Dovobet (R)/Taclonex (R)) compared to a morning/evening non-fix calcipotriol/betamethasone combination in psoriasis treatment. Methods: A Markov model (discrete-time stochastic process based on transitions between health states) with 2 treatment arms (Daivobet/Dovobet/Taclonex vs. non-fix calcipotriol/betamethasone) over a 48-week time period was developed. The effectiveness criterion was the number of days with clearance or marked improvement. Clinical and health resource utilisation data were derived from randomised studies. Results: Treatment with Daivobet/Dovobet/Taclonex showed a higher cost-effectiveness compared to the non-fix combination, even when assuming a maximum compliance for the twice daily non-fix combination and varying the effectiveness of Daivobet/Dovobet/Taclonex by 10%. Conclusion: Psoriasis treatment with a fix calcipotriol/betamethasone combination is more cost-effective than a non-fix morning/evening combination. Copyright (C) 2007 S. Karger AG, Basel.