Economic Impact of Home-Use versus Office-Use Diphenylcyclopropenone in Extensive Alopecia Areata

Abstract

<b><i>Introduction:</i></b> Diphenylcyclopropenone (DPCP) is the medication of choice for the treatment of severe alopecia areata (AA) according to AA treatment guidelines. Precise initiation and application are important factors for successful treatment. However, it is difficult for patients who live far away to visit their doctor weekly. <b><i>Methods:</i></b> We conducted a retrospective cohort study to assess the cost, effectiveness, and side effects of DPCP treatment between office-use DPCP (O-DPCP) and home-use DPCP (H-DPCP) in severe AA patients. A cost-effectiveness analysis was performed from the perspective of healthcare providers and patients using real-world data and the national cost statistics for hospital services comparing O-DPCP and H-DPCP in patients with severe AA at 24, 36, and 48 weeks. <b><i>Results:</i></b> Two groups of 41 patients treated with O-DPCP and H-DPCP were enrolled. There was no significant difference in the proportion of patients who showed a favorable outcome (≥50% improvement) with minimal side effects between both groups at 24 (O-DPCP 43.9% vs. H-DPCP 26.8%, <i>p</i> = 0.11), 36 (O-DPCP 58.5% vs. H-DPCP 43.9%, <i>p</i> = 0.19), or 48 weeks (O-DPCP 63.4% vs. H-DPCP 56.1%, <i>p</i> = 0.49). The cost of H-DPCP was half of the cost of O-DPCP. <b><i>Discussion/Conclusion:</i></b> H-DPCP is a cost-effective and time-efficient alternative treatment option for severe AA patients.

Effectiveness of oral tofacitinib treatment on patients with moderate‐to‐severe alopecia areata in Iran

“…In this study, as in the most studies, cases treated with a dosage of 5 mg twice a day of tofacitinib were followed after 6 month 18,28,29 . The average maintenance dose of the drug in our study was 7 mg daily, which reduced the risk of any side effects caused by increasing the dose of the drug.…”

Evaluating the Cost Burden of Alopecia Areata Treatment: A Comprehensive Review for Dermatologists

“…Most of the annual cost burden of DPC treatment was due to staff time and overhead rather than the cost of the DPC itself: $258 for the DPC, $978 in staff time and overhead for the department, and $1233 directly charged to the patient. 21 Lekhavat et al 22 studied the economic impact of home-use vs office-use DPC in extensive AA (N=82). Both groups received weekly treatments in the hospital until DPC concentrations had been adjusted.…”

“…There was no significant difference between groups in the proportion of patients who responded favorably to the DPC. 22 JAK Inhibitors-Chen et al 23 studied the efficacy of low-dose (5 mg) tofacitinib to treat severe AA (N=6). Compared to prior studies, [24][25][26][27] this analysis reported the efficacy of low-dose tofacitinib was not inferior to higher doses (10-20 mg), and low-dose tofacitinib reduced treatment costs by more than 50%.…”

“…Three of 10 articles studied global costs of AA, 1 studied costs of concealment, 3 studied costs of minoxidil, 2 studied costs of DPC, and 2 studied costs of JAK inhibitors. Only 2 studies achieved level of evidence 1a: the first assessed the economic impact of home-use vs office-use DPC, 22 and the second researched the efficacy and outcomes of JAK inhibitors. 29 Hair-loss treatments and concealment techniques cost the average patient thousands of dollars.…”

Home‐based diphenylcyclopropenone immunotherapy for alopecia areata: A large retrospective study of 94 cases

“…Until now, only a few retrospective studies have been published on the effectiveness and safety of home-based contact immunotherapy. [4][5][6][7] This study included the largest number of AA patients, including children, and further evaluated the convenience and economic burden as well as the efficacy and safety of home-based DPCP-immunotherapy.…”