Cost Effectiveness of Biologic Therapies for Plaque Psoriasis

Ahn, Christine S.; Gustafson, Cheryl J.; Sandoval, Laura F.; Davis, Scott; Feldman, Steven R.

doi:10.1007/s40257-013-0030-z

Cited by 59 publications

(86 citation statements)

References 37 publications

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“…Every decision made on patient treatment should take into the consideration impact on the quality of life [58]. Validated commonly used life quality questionnaires should be inevitable part of each registry.…”

Section: Discussionmentioning

confidence: 99%

Centralised Biological Therapy Registry for Moderate to Severe Plaque Psoriasis – Overview and Methodology

Sutka

Pecova

2016

Acta Medica Martiniana

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A b s t r a c tThe introduction of new pharmacotherapy entities in the last decade accentuate the necessity to set up treatment guidelines based on real life evidence. Randomized controlled trials remain golden standard of a research. Data derived from studies aiming on daily clinical practice should bring needed, added value. Disease prevalence growth, due to increased life expectancy, better diagnostic procedures and earlier medical intervention, as well as ever growing demand for highly priced, sophistically produced drugs put stress on healthcare budgets even in developed countries. Large databases commonly called -therapy registries are implemented to collect data on therapy effectivity in terms of effectiveness, safety and patient long-term on therapy survival. Registries importance rose together with biological therapies introduction. New in class molecules entered the market conditionally being obliged to provide additional e.g. safety data. Such procedures require involvement of many different professionals, e.g. physicians, professional medical bodies, IT experts, database administrators, statisticians and government institutions. Paper based, followed by computer based forms were distributed among physicians to collect these data. eHealth technologies provide physicians with centralized, more intuitive applications. The particularities of different diagnosis caused great variations within each specific registry launched. Important information was missing since they were pointed out as optional and many were redundant causing frustration among physicians due to inadequate administrative workload. The main objective of this work was to set up the therapy registry standards and procedures. Methodology of "ideal" moderate to severe plaque psoriasis biology therapy registry development, introduction, administration and evaluation was prepared to assist any government institution or professional body when planning registry deployment. Electronic application based on widely used MS Excel platform was developed and installed in the biological therapy centers as a standalone application for the pilot use.

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Section: Discussionmentioning

confidence: 99%

Centralised Biological Therapy Registry for Moderate to Severe Plaque Psoriasis – Overview and Methodology

Sutka

Pecova

2016

Acta Medica Martiniana

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“…High costs associated with biologics and systemic agents are associated with their side effects. As pre-treatment assessment and screening tests are required to be conducted to identify those at risk of developing toxicity, the cost of therapy will accumulate (Ahn et al 2013;Affandi & Adnan 2012). For example, the most common Acitretin (systemic agent) related side effect is hyperlipidemia which may develop in 33% of patients treated with acitretin.…”

Section: Problem Statementmentioning

confidence: 99%

Economic Burden and Cost Effectiveness Analysis of Psoriasis Treatment Modalities in Malaysian Public Hospitals: A Study Protocol

Sulong¹,

Ismail²,

Azizam³

et al. 2016

European Proceedings of Social &Amp; Behavioural Sciences

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There is limited evidence on the economic burden and cost effectiveness of psoriasis treatment modalities in this region. This study aims to evaluate the economic burden and cost effectiveness analysis of four Psoriasis treatment modalities in Malaysian public hospitals. This is a prospective cohort study involving a total of 523 moderate to severe psoriasis patients (Psoriasis Area Severity Index (PASI)>10and/or Body Surface Area (BSA)>10 and/or Dermatology Life Quality Life (DLQI)>10) recruited from five public hospitals in Malaysia via consecutive sampling technique. The duration of the data collection is 12 months (6 months recruitment and 6 months follow up). Inclusion criteria include new or existing moderate to severe psoriasis patients who started with new treatment modalities at the time of the recruitment period, Malaysians, aged 18 years and above and who are willing to participate. The costs are calculated from the societal perspective. Provider costs are calculated by estimating recurrent costs (emolument, consumables, utility, maintenance and training) and direct costs (drugs, laboratory investigation, procedural examination). Patient costs components are direct and indirect costs. Direct costs include treatment cost (traditional medicines), out of pocket expenses (over the counter drugs, skin supplements and products). Indirect costs covers transportation and loss of productivity. Economic burden is measured by multiplying the total cost with the prevalence of psoriasis. Effectiveness of the treatment modalities is assessed based on PASI, BSA and DLQI scores (outcomes). PASI-75 (75% reduction of PASI score from baseline score), BSA<5 and DLQI≤5 (disease has no or minimal impact on quality of life) is considered effective. The least cost per outcome is the most cost effective treatment.

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“…The main assumptions include patient compliance or adherence to treatments [49,60], length of treatment [31], productivity costs [58,62], hospitalization for non-responders [24,62,67], defining responders by PASI 90 (a 90 % reduction in the PASI score) [32] or PASI 50 (a 50 % reduction) [62] instead of PASI 75 (a 75 % reduction), a treatment-free response period [21], responding patients withdrawing from treatment [35,40], reduced response upon re-treatment [59], and disutility on intermittent therapy [62]. Furthermore, more than one time horizon was applied in some studies [23,32,35,40,46,48,60,71]. We found that in 20 studies, the sensitivity analyses had no impact on the final conclusions, whereas in 14 other studies, the cost-effectiveness conclusions were affected.…”

Section: Within the Studymentioning

confidence: 99%

“…According to the 18 studies where we found a definite or potential impact of uncertain variables or assumptions on the final conclusions, the key drivers included (1) the costs of the medication or phototherapy itself, or related assumptions such as dosage, a treatment-free response period, average wholesale price, and weight and waste of excess medications [21,24,27,34,40,43,46,50,51,61,62,71]; (2) the values of efficacy measures, which include PASI response rate, DLQI response rate (a minimally important difference [MID]), clearing rate, response rate achieved in re-treatment [23,26,27,34,40,46,59,61], and the choice of efficacy measures, PASI 75 or DLQI MID [34]; (3) utility values, which comprised of those with different disease severity levels or PASI response health states, baseline utility values, and utility ratings for side effects, or being on the waiting list [22,26,51,57,67]; (4) hospitalization assumptions for non-responders [24,62,67]; (5) considering lost productivity during hospitalization [62]; and (6) different time horizons [40]. …”

Section: Within the Studymentioning

confidence: 99%