The Cost Effectiveness of Tapered versus Abrupt Discontinuation of Oral Cyclosporin Microemulsion for the Treatment of Psoriasis

Authors: Hakkaart-van Roijen L.; Verboom P.; Redekop W.K.; Touw K.R.; Rutten F.F.H.

Source: PharmacoEconomics, Volume 19, Number 5, 2001 , pp. 599-608(10)

Publisher: Adis International

Abstract:

Objective: To assess the cost effectiveness of tapered versus abrupt discontinuation of a microemulsion formulation of cyclosporin in patients with chronic plaque psoriasis.

Methods: A cost-effectiveness analysis was performed in parallel with a nonblind, multicentre, international clinical trial of the safety and efficacy of intermittent short courses of cyclosporin. Direct and indirect costs were considered within a 1-year period following randomisation.

Patients: Patients with chronic plaque psoriasis inadequately controlled with topical treatment.

Study perspective: The study was conducted from a societal perspective and was performed using data from Canada, Spain, Turkey and the UK.

Main outcomes measures: The health outcome used was the total number of systemic therapy-free days (STFDs) over the first year. The mean incremental cost-effectiveness ratio (ICER) was determined by dividing the differences in average cost per patient by the differences in average STFDs per patient.

Results: The overall ICER was dominant because tapered discontinuation was associated with both lower costs and improved efficacy in comparison with abrupt discontinuation. Further analyses showed that tapered discontinuation was a cost-effective alternative to abrupt discontinuation therapy, even when a conservative definition for cost effectiveness was adopted.

Conclusion: This cost-effectiveness analysis demonstrated that tapering cyclosporin was more cost effective than abruptly stopping cyclosporin in patients with chronic plaque psoriasis.

Keywords: Antipsoriatics, therapeutic use; Cost effectiveness; Cyclosporin modified, therapeutic use; Drug withdrawal; Pharmacoeconomics; Psoriasis, treatment

Language: English

Document Type: Original article

Affiliations: 1: Institute for Medical Technology Assessment, Erasmus University, Rotterdam, The Netherlands *

Publication date: 2001-01-01

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• In this Subject: Pharmacology
• By this author: Hakkaart-van Roijen L. ;  Verboom P. ;  Redekop W.K. ;  Touw K.R. ;  Rutten F.F.H.

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