An economic evaluation of the randomized controlled trial of topical corticosteroid and home-based narrowband ultraviolet B for active and limited vitiligo (the HI-Light Vitiligo Trial)

Sach, Tracey ORCID: https://orcid.org/0000-0002-8098-9220, Thomas, K. S., Batchelor, J. M., Akram, P., Chalmers, J. R., Haines, R. H., Meakin, G. D., Duley, Leila, Ravenscroft, J. C., Rogers, A., Santer, M., Tan, W., White, J., Whitton, M. E., Williams, H. C., Cheung, S. T., Hamad, H., Wright, A., Ingram, J. R., Levell, Nick ORCID: https://orcid.org/0000-0003-3393-8305, Goulding, J. M. R., Makrygeorgou, A., Bewley, A., Ogboli, M., Stainforth, J., Ferguson, A., Laguda, B., Wahie, S., Ellis, R., Azad, J., Rajasekaran, A., Eleftheriadou, V. and Montgomery, A. A. (2021) An economic evaluation of the randomized controlled trial of topical corticosteroid and home-based narrowband ultraviolet B for active and limited vitiligo (the HI-Light Vitiligo Trial). British Journal of Dermatology, 184 (5). pp. 840-848. ISSN 0007-0963

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Abstract

Background: Economic evidence for vitiligo treatments is absent. Objectives: To determine the cost-effectiveness of (i) handheld narrowband ultraviolet B (NB-UVB) and (ii) a combination of topical corticosteroid (TCS) and NB-UVB compared with TCS alone for localized vitiligo. Methods: Cost-effectiveness analysis alongside a pragmatic, three-arm, placebo-controlled randomized controlled trial with 9 months’ treatment. In total 517 adults and children (aged ≥ 5 years) with active vitiligo affecting < 10% of skin were recruited from secondary care and the community and were randomized 1: 1: 1 to receive TCS, NB-UVB or both. Cost per successful treatment (measured on the Vitiligo Noticeability Scale) was estimated. Secondary cost–utility analyses measured quality-adjusted life-years using the EuroQol 5 Dimensions 5 Levels for those aged ≥ 11 years and the Child Health Utility 9D for those aged 5 to < 18 years. The trial was registered with number ISRCTN17160087 on 8 January 2015. Results: The mean ± SD cost per participant was £775 ± 83·7 for NB-UVB, £813 ± 111.4 for combination treatment and £600 ± 96·2 for TCS. In analyses adjusted for age and target patch location, the incremental difference in cost for combination treatment compared with TCS was £211 (95% confidence interval 188–235), corresponding to a risk difference of 10·9% (number needed to treat = 9). The incremental cost was £1932 per successful treatment. The incremental difference in cost for NB-UVB compared with TCS was £173 (95% confidence interval 151–196), with a risk difference of 5·2% (number needed to treat = 19). The incremental cost was £3336 per successful treatment. Conclusions: Combination treatment, compared with TCS alone, has a lower incremental cost per additional successful treatment than NB-UVB only. Combination treatment would be considered cost-effective if decision makers are willing to pay £1932 per additional treatment success.

Item Type: Article
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
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Depositing User: LivePure Connector
Date Deposited: 18 Sep 2020 00:31
Last Modified: 22 Oct 2022 07:04
URI: https://ueaeprints.uea.ac.uk/id/eprint/76928
DOI: 10.1111/bjd.19554

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