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Cost-effectiveness and cost-benefit analysis of using methotrexate vs Goeckerman therapy for psoriasis. A pilot study.

Publication ,  Journal Article
Chen, S; Shaheen, A; Garber, A
Published in: Arch Dermatol
December 1998

OBJECTIVE: To analyze the net benefit and cost-effectiveness of methotrexate use and Goeckerman therapy for psoriasis. DESIGN: Net benefit and cost-effectiveness depend on the costs, efficacy, and utilities of therapy. Utilities are quantitative measures of patient preferences. We obtained costs by using resource-based accounting techniques. Efficacy was estimated from literature reports. We surveyed patients with psoriasis, dermatologists, and healthy subjects using utility assessment methods. All assumptions were examined in a sensitivity analysis. MAIN OUTCOME MEASURES: For net benefit, if benefits out-weighed the costs, it was deemed worth providing. For the cost-effectiveness analysis, the ratio of costs-to-effectiveness of less than $35,000 was considered cost-effective. RESULTS: Using utilities from healthy nonexperts, the costs of both therapies exceeded the benefits in mild and moderate psoriasis. In severe psoriasis, only methotrexate demonstrates a net benefit. Both therapies were cost-effective compared with no therapy. Liquid methotrexate should be chosen over the tablet form since it was cheaper and had the same outcome. Goeckerman was cost-effective against liquid methotrexate in severe, but not mild or moderate psoriasis. There was a trend for therapies to be more cost-effective when using patient utilities and less with dermatologist utilities. The results were highly sensitive to efficacy and utilities. CONCLUSIONS: The results of this study need to be confirmed in other settings, but they demonstrate that the tools of cost-effectiveness and cost-benefit analysis have great potential value in dermatology. Once efficacy is better characterized and utilities better quantified, these types of analyses will be crucial for health care policy.

Duke Scholars

Published In

Arch Dermatol

DOI

ISSN

0003-987X

Publication Date

December 1998

Volume

134

Issue

12

Start / End Page

1602 / 1608

Location

United States

Related Subject Headings

  • Ultraviolet Therapy
  • Sensitivity and Specificity
  • Psoriasis
  • Pilot Projects
  • Methotrexate
  • Humans
  • Dermatology & Venereal Diseases
  • Dermatologic Agents
  • Cost-Benefit Analysis
  • 3202 Clinical sciences
 

Citation

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Chen, S., Shaheen, A., & Garber, A. (1998). Cost-effectiveness and cost-benefit analysis of using methotrexate vs Goeckerman therapy for psoriasis. A pilot study. Arch Dermatol, 134(12), 1602–1608. https://doi.org/10.1001/archderm.134.12.1602
Chen, S., A. Shaheen, and A. Garber. “Cost-effectiveness and cost-benefit analysis of using methotrexate vs Goeckerman therapy for psoriasis. A pilot study.Arch Dermatol 134, no. 12 (December 1998): 1602–8. https://doi.org/10.1001/archderm.134.12.1602.
Chen, S., et al. “Cost-effectiveness and cost-benefit analysis of using methotrexate vs Goeckerman therapy for psoriasis. A pilot study.Arch Dermatol, vol. 134, no. 12, Dec. 1998, pp. 1602–08. Pubmed, doi:10.1001/archderm.134.12.1602.

Published In

Arch Dermatol

DOI

ISSN

0003-987X

Publication Date

December 1998

Volume

134

Issue

12

Start / End Page

1602 / 1608

Location

United States

Related Subject Headings

  • Ultraviolet Therapy
  • Sensitivity and Specificity
  • Psoriasis
  • Pilot Projects
  • Methotrexate
  • Humans
  • Dermatology & Venereal Diseases
  • Dermatologic Agents
  • Cost-Benefit Analysis
  • 3202 Clinical sciences