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Economic footprint of psoriasis treatment inconclusive

To address limitations and identify patient preferences and barriers to psoriasis treatment, new integrated clinical and economic research is needed, according to researchers.

After searching the EMBASE, Medline and NHS Economic Evaluation electronic databases for full economic evaluations conducted in January 2012, the researchers identified 1,355 articles, and 37 papers were included for evaluation. The researchers reviewed systemic, topical, phototherapies and combination therapies to determine the cost-effectiveness of current psoriasis care, as well as to assess the uncertainty and transferability of such evidence to both policy and practice, and to identify future research needs.

The economic evaluations were constrained by limited availability of high-quality, short- and long-term head-to-head comparisons of the effectiveness, safety and adherence of different interventions, according to the researchers. Additionally, most articles evaluated therapeutic agents, not packages of care.

The researchers also found there was no consistent evidence about the relative cost-effectiveness of currently available biologic therapies.
Most comparisons evaluated multiple active treatments against placebo to give an implicit, indirect comparison between active interventions for net costs, net outcome and incremental cost-effectiveness ratios, and few studies compared the range of therapies representing the options available in standard care, according to the researchers.

Thirty-nine comparisons in 23 articles excluded adverse events, underestimating costs and over-estimating health benefit. Furthermore, most studies did not account for treatment adherence in their analysis, the researchers found.

As psoriasis is often a lifetime condition, the researchers reported that most analyses evaluated cost-effectiveness over short time periods of 1 year or less.

The researchers concluded that, going forward, research needs to incorporate longer follow-up and use generic measures of health to account for treatment side effects.

Disclosures: Hamilton has received speaking and consulting fees from Leading Edge Group for a project funded by Pfizer. Griffiths has received honoria and/or research grants from AbbVie, Amgen, Galderma, Janssen, LEO, Lilly, MSD, Novartis, Pfizer, Sandoz, Trident and UCB.