Phototherapy achieves significant cost savings by the delay of drug based treatment in psoriasis

John Foerster (Lead / Corresponding author), Robert Dawe

Research output: Contribution to journalArticle

Abstract

Background: Although used for decades in psoriasis, access to phototherapy is becoming increasingly restricted. Besides patient inconvenience, this is in large part to do with a perception of 'high cost'. We previously reported a comprehensive analysis of direct and indirect phototherapy treatment cost. However, no robust data exist on the actual savings associated with providing phototherapy in the treatment pathway.

Objectives: To quantify the cost savings achieved by phototherapy by delaying alternative treatments.

Methods: Costs accruing through the UK-wide established treatment pathway with and without phototherapy were analyzed. Direct and indirectly incurred drug treatment costs were calculated using drug tariff, lab cost, estate rates, and clinic review costs. To enhance reliability, ranges of cost scenarios were calculated by varying parameters such as drug dosing.

Results: Medium annual cost savings per patient were £2200 [range: £1800 - £2900] for NB-UVB, and £3700 [range: £2500 - £5300] if both NB-UVB and PUVA courses were administered, respectively. As the provider treated 656 ± 76 patients per year during the six- year observational window, this amounted to savings of £Mio 2.4 [range: £Mio 1.6 - £Mio 3.4], even excluding additional non-modelled drug-associated costs (e.g. diagnostics, adverse event management). Since we only consider cost-savings by delay of drug treatment for the duration of phototherapy, drug price reductions through biosimilar introduction only have a small effect. We provide spreadsheets allowing adaptation cost savings projections by varying input variables.

Conclusions: Health care providers may achieve significant cost savings by implementing and/or widening access to phototherapy.

Original languageEnglish
JournalPhotodermatology, Photoimmunology & Photomedicine
DOIs
Publication statusE-pub ahead of print - 13 Sep 2019

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Phototherapy
Cost Savings
Psoriasis
Pharmaceutical Preparations
Costs and Cost Analysis
Drug Costs
Biosimilar Pharmaceuticals
Health Care Costs
Therapeutics
Health Personnel

Keywords

  • health economics
  • NB-UVB
  • psoriasis
  • treatment pathways

Cite this

@article{e7842fe5b3624e3d921d2297ae7b0e41,
title = "Phototherapy achieves significant cost savings by the delay of drug based treatment in psoriasis",
abstract = "Background: Although used for decades in psoriasis, access to phototherapy is becoming increasingly restricted. Besides patient inconvenience, this is in large part to do with a perception of 'high cost'. We previously reported a comprehensive analysis of direct and indirect phototherapy treatment cost. However, no robust data exist on the actual savings associated with providing phototherapy in the treatment pathway.Objectives: To quantify the cost savings achieved by phototherapy by delaying alternative treatments.Methods: Costs accruing through the UK-wide established treatment pathway with and without phototherapy were analyzed. Direct and indirectly incurred drug treatment costs were calculated using drug tariff, lab cost, estate rates, and clinic review costs. To enhance reliability, ranges of cost scenarios were calculated by varying parameters such as drug dosing.Results: Medium annual cost savings per patient were £2200 [range: £1800 - £2900] for NB-UVB, and £3700 [range: £2500 - £5300] if both NB-UVB and PUVA courses were administered, respectively. As the provider treated 656 ± 76 patients per year during the six- year observational window, this amounted to savings of £Mio 2.4 [range: £Mio 1.6 - £Mio 3.4], even excluding additional non-modelled drug-associated costs (e.g. diagnostics, adverse event management). Since we only consider cost-savings by delay of drug treatment for the duration of phototherapy, drug price reductions through biosimilar introduction only have a small effect. We provide spreadsheets allowing adaptation cost savings projections by varying input variables.Conclusions: Health care providers may achieve significant cost savings by implementing and/or widening access to phototherapy.",
keywords = "health economics, NB-UVB, psoriasis, treatment pathways",
author = "John Foerster and Robert Dawe",
note = "No external funding. {\circledC} 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.",
year = "2019",
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day = "13",
doi = "10.1111/phpp.12511",
language = "English",
journal = "Photodermatology, Photoimmunology & Photomedicine",
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T1 - Phototherapy achieves significant cost savings by the delay of drug based treatment in psoriasis

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AU - Dawe, Robert

N1 - No external funding. © 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

PY - 2019/9/13

Y1 - 2019/9/13

N2 - Background: Although used for decades in psoriasis, access to phototherapy is becoming increasingly restricted. Besides patient inconvenience, this is in large part to do with a perception of 'high cost'. We previously reported a comprehensive analysis of direct and indirect phototherapy treatment cost. However, no robust data exist on the actual savings associated with providing phototherapy in the treatment pathway.Objectives: To quantify the cost savings achieved by phototherapy by delaying alternative treatments.Methods: Costs accruing through the UK-wide established treatment pathway with and without phototherapy were analyzed. Direct and indirectly incurred drug treatment costs were calculated using drug tariff, lab cost, estate rates, and clinic review costs. To enhance reliability, ranges of cost scenarios were calculated by varying parameters such as drug dosing.Results: Medium annual cost savings per patient were £2200 [range: £1800 - £2900] for NB-UVB, and £3700 [range: £2500 - £5300] if both NB-UVB and PUVA courses were administered, respectively. As the provider treated 656 ± 76 patients per year during the six- year observational window, this amounted to savings of £Mio 2.4 [range: £Mio 1.6 - £Mio 3.4], even excluding additional non-modelled drug-associated costs (e.g. diagnostics, adverse event management). Since we only consider cost-savings by delay of drug treatment for the duration of phototherapy, drug price reductions through biosimilar introduction only have a small effect. We provide spreadsheets allowing adaptation cost savings projections by varying input variables.Conclusions: Health care providers may achieve significant cost savings by implementing and/or widening access to phototherapy.

AB - Background: Although used for decades in psoriasis, access to phototherapy is becoming increasingly restricted. Besides patient inconvenience, this is in large part to do with a perception of 'high cost'. We previously reported a comprehensive analysis of direct and indirect phototherapy treatment cost. However, no robust data exist on the actual savings associated with providing phototherapy in the treatment pathway.Objectives: To quantify the cost savings achieved by phototherapy by delaying alternative treatments.Methods: Costs accruing through the UK-wide established treatment pathway with and without phototherapy were analyzed. Direct and indirectly incurred drug treatment costs were calculated using drug tariff, lab cost, estate rates, and clinic review costs. To enhance reliability, ranges of cost scenarios were calculated by varying parameters such as drug dosing.Results: Medium annual cost savings per patient were £2200 [range: £1800 - £2900] for NB-UVB, and £3700 [range: £2500 - £5300] if both NB-UVB and PUVA courses were administered, respectively. As the provider treated 656 ± 76 patients per year during the six- year observational window, this amounted to savings of £Mio 2.4 [range: £Mio 1.6 - £Mio 3.4], even excluding additional non-modelled drug-associated costs (e.g. diagnostics, adverse event management). Since we only consider cost-savings by delay of drug treatment for the duration of phototherapy, drug price reductions through biosimilar introduction only have a small effect. We provide spreadsheets allowing adaptation cost savings projections by varying input variables.Conclusions: Health care providers may achieve significant cost savings by implementing and/or widening access to phototherapy.

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