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Cost-effectiveness of oral alitretinoin in patients with severe chronic hand eczema--a long-term analysis from a Swiss perspective.

Blank PR, Blank AA, Szucs TD - BMC Dermatol. (2010)

Bottom Line: Accordingly, the incremental cost-effectiveness ratio resulted in 14'816 euro/QALY gained.These results were robust to changes in key model assumptions.In our long-term model we identified the treatment with alitretinoin as a cost-effective alternative for the therapy of CHE patients in Switzerland.

View Article: PubMed Central - HTML - PubMed

Affiliation: ECPM Institute of Pharmaceutical Medicine, University of Basel, Klingelbergstrasse 61, 4056 Basel, Switzerland.

ABSTRACT

Background: The impact on patients suffering from chronic hand eczema (CHE) is enormous, as no licensed systemic treatment option with proven efficacy for CHE is available. Alitretinoin is a novel agent which showed high clinical efficacy in patients with severe, refractory CHE. We assessed the cost-effectiveness of alitretinoin for CHE patient treatment from a Swiss third party payer perspective. A further objective of this study was to determine the burden of disease in Switzerland.

Methods: A long-term Markov cohort simulation model was used to estimate direct medical costs (euro) and clinical effectiveness (quality adjusted life years, QALYs) of treating severe CHE patients with alitretinoin. Comparison was against the standard treatment of supportive care (optimised emollient therapy). Information on response rates were derived from a randomized controlled clinical trial. Costs were considered from the perspective of the Swiss health system. Swiss epidemiological data was derived from official Swiss Statistic institutions.

Results: Annual costs of alitretinoin treatment accounted for 2'212 euro. After a time horizon of 22.4 years, average remaining long-term costs accounted for 42'208 euro or 38'795 euro in the alitretinoin and the standard treatment arm, respectively. Compared with the standard therapy, the addition of alitretinoin yielded an average gain of 0.230 QALYs at the end of the simulation. Accordingly, the incremental cost-effectiveness ratio resulted in 14'816 euro/QALY gained. These results were robust to changes in key model assumptions.

Conclusion: The therapy for CHE patients is currently insufficient. In our long-term model we identified the treatment with alitretinoin as a cost-effective alternative for the therapy of CHE patients in Switzerland.

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Related in: MedlinePlus

Scenarios of sensitivity analysis.
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Figure 2: Scenarios of sensitivity analysis.

Mentions: Several one-way sensitivity analyses were performed in order to guarantee the models' insensitiveness to particular parameter variations. For the analyses, model parameters were selected as described in the methods and were tested for their impact on the base case result. The impact of the scenario analyses (± 30% or ± 35% variation of selected parameters) on ICER results was minor (Figure 2).


Cost-effectiveness of oral alitretinoin in patients with severe chronic hand eczema--a long-term analysis from a Swiss perspective.

Blank PR, Blank AA, Szucs TD - BMC Dermatol. (2010)

Scenarios of sensitivity analysis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2908557&req=5

Figure 2: Scenarios of sensitivity analysis.
Mentions: Several one-way sensitivity analyses were performed in order to guarantee the models' insensitiveness to particular parameter variations. For the analyses, model parameters were selected as described in the methods and were tested for their impact on the base case result. The impact of the scenario analyses (± 30% or ± 35% variation of selected parameters) on ICER results was minor (Figure 2).

Bottom Line: Accordingly, the incremental cost-effectiveness ratio resulted in 14'816 euro/QALY gained.These results were robust to changes in key model assumptions.In our long-term model we identified the treatment with alitretinoin as a cost-effective alternative for the therapy of CHE patients in Switzerland.

View Article: PubMed Central - HTML - PubMed

Affiliation: ECPM Institute of Pharmaceutical Medicine, University of Basel, Klingelbergstrasse 61, 4056 Basel, Switzerland.

ABSTRACT

Background: The impact on patients suffering from chronic hand eczema (CHE) is enormous, as no licensed systemic treatment option with proven efficacy for CHE is available. Alitretinoin is a novel agent which showed high clinical efficacy in patients with severe, refractory CHE. We assessed the cost-effectiveness of alitretinoin for CHE patient treatment from a Swiss third party payer perspective. A further objective of this study was to determine the burden of disease in Switzerland.

Methods: A long-term Markov cohort simulation model was used to estimate direct medical costs (euro) and clinical effectiveness (quality adjusted life years, QALYs) of treating severe CHE patients with alitretinoin. Comparison was against the standard treatment of supportive care (optimised emollient therapy). Information on response rates were derived from a randomized controlled clinical trial. Costs were considered from the perspective of the Swiss health system. Swiss epidemiological data was derived from official Swiss Statistic institutions.

Results: Annual costs of alitretinoin treatment accounted for 2'212 euro. After a time horizon of 22.4 years, average remaining long-term costs accounted for 42'208 euro or 38'795 euro in the alitretinoin and the standard treatment arm, respectively. Compared with the standard therapy, the addition of alitretinoin yielded an average gain of 0.230 QALYs at the end of the simulation. Accordingly, the incremental cost-effectiveness ratio resulted in 14'816 euro/QALY gained. These results were robust to changes in key model assumptions.

Conclusion: The therapy for CHE patients is currently insufficient. In our long-term model we identified the treatment with alitretinoin as a cost-effective alternative for the therapy of CHE patients in Switzerland.

Show MeSH
Related in: MedlinePlus