A cost-effectiveness analysis of calcipotriol plus betamethasone dipropionate aerosol foam versus gel for the topical treatment of plaque psoriasis

Abstract

Background: Calcipotriol 50 µg/g and betamethasone 0.5 mg/g dipropionate (Cal/BD) aerosol foam formulation provides greater effectiveness and improved patient preference compared with traditional Cal/BD formulations for the topical treatment of plaque psoriasis.

Objective: To determine the cost-effectiveness of Cal/BD foam compared with Cal/BD gel from the Australian perspective.

Methods: A Markov model was developed to evaluate the cost-effectiveness of topical Cal/BD foam and gel for the treatment of people with plaque psoriasis. Treatment effectiveness, safety, and utilities were based on a randomized control trial, resource use was informed by expert opinion, and unit costs were obtained from public sources. Outcomes were reported in terms of 1-year costs, quality-adjusted life years, and incremental cost-effectiveness ratios. All costs were reported in 2017 Australian Dollars.

Results: The model showed that patients using Cal/BD foam had more QALYs and higher costs over 1 year compared with patients using Cal/BD gel, resulting in a cost of $13,609 per QALY gained at 4-weeks. When 4 weeks of Cal/BD foam was compared with 8 weeks of Cal/BD gel treatment, Cal/BD foam was $8 less expensive and resulted in 0.006 more QALYs gained. Sensitivity analyses showed that, compared with Cal/BD ointment, Cal/BD foam was associated with an incremental cost of $15,091 per QALY gained.

Conclusion: Cal/BD foam is the most cost-effective Cal/BD formulation for the topical treatment of patients with plaque psoriasis.

Keywords:

• Betamethasone dipropionate
• calcipotriol
• cost
• cost-effectiveness
• psoriasis
• quality-of-life
• steroids

Transparency

Declaration of funding

The contents of the paper and the opinions expressed within are those of the authors, and it was the decision of the authors to submit the manuscript for publication.

Declaration of financial/other relationships

P.F. has disclosed grant and personal fees from AbbVie, Amgen, Celgene, LEO, Lilly, Janssen, Novartis, Merck, Valeant, Galderma, Roche, and Sanofi. P.F. has also acted as an investigator in clinical trials for AbbVie, Merck, Valeant, UCB, BMS, Galderma, Gentech, GSK, Roche, Sanofi, Amgen, Celgene, LEO, Lilly, Janssen, and Boehringer Ingelheim. P.F. has received personal fees from Sun Pharma, UCB, and GSK. S.G. reports being contracted to deliver health economics services for publications from the Pharmaceutical Benefits Advisory Committee. L.R. is an employee of LEO Pharma. Peer reviewers on this manuscript have received an honorarium from CMRO for their review work. Two peer-reviewers have disclosed considerable support from Leo and from other companies that make products for psoriasis, and funding support from Johnson and Johnson, respectively.

Acknowledgment

The authors thank Laura Sawyer and Sarah Bermingham of Symmetron Ltd for providing scientific review and editorial assistance.