Value in psoriasis (IRIS) trial: implementing value-based healthcare in psoriasis management – a 1-year prospective clinical study to evaluate feasibility and value creation

Abstract

IntroductionCurrently, the healthcare sector is under tremendous financial pressure, and many acknowledge that a dramatic shift is required as the current system is not sustainable. Furthermore, the quality of care that is delivered varies strongly. Several solutions have been proposed of which the conceptual framework known as value-based healthcare (VBHC) is further explored in this study for psoriasis. Psoriasis is a chronic inflammatory skin disease, which is associated with a high disease burden and high treatment costs. The objective of this study is to investigate the feasibility of using the VBHC framework for the management of psoriasis.Methods and analysisThis is a prospective clinical study in which new patients attending the psoriasis clinic (PsoPlus) of the Ghent University Hospital will be followed up during a period of 1 year. The main outcome is to determine the value created for psoriasis patients. The created value will be considered as a reflection of the evolution of the value score (ie, the weighted outputs (outcomes) divided by weighted inputs (costs)) obtained using data envelopment analysis. Secondary outcomes are related to comorbidity control, outcome evolution and treatment costs. In addition, a bundled payment scheme will be determined as well as potential improvements in the treatment process. A total of 350 patients will be included in this trial and the study initiation is foreseen on 1 March 2023.Ethics and disseminationThis study has been approved by the Ethics Committee of the Ghent University Hospital. The findings of this study will be disseminated by various means: (1) publication in one or more peer-reviewed dermatology and/or management journals, (2) (inter)national congresses, (3) via the psoriasis patient community and (4) through the research team’s social media channels.Trial registration numberNCT05480917.

Balancing outcomes and costs for best value in psoriasis

“…Time-driven activity based costing (TDABC) is recommended as the best system to measure the costs (not to be confused with payment based on reimbursement codes) for a patient. 4 Using process maps and costs per minute of practical capacity for each of the resources used, a cost per patient can be calculated. For the evaluation of value initiatives, an analysis of the patient cost is equally important and often not studied.…”

“…We have recently described the setup of a psoriasis IPU and are now collecting data and analysing the results. 4…”

“…An IPU is an organizational entity that connects specialisms and functions to effectively manage the end‐to‐end spectrum of medical conditions. We have recently described the setup of a psoriasis IPU and are now collecting data and analysing the results 4 …”