An economic evaluation of the randomised controlled trial of topical corticosteroid and home‐based narrowband UVB for active and limited vitiligo (The HI‐Light Trial)

Sach, Tracey, 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, 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. (2020) An economic evaluation of the randomised controlled trial of topical corticosteroid and home‐based narrowband UVB for active and limited vitiligo (The HI‐Light Trial). British Journal of Dermatology. ISSN 0007-0963

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Abstract

Background: Economic evidence for vitiligo treatments is absent. Objective: To determine the cost‐effectiveness of (a) hand‐held narrowband‐UVB (NB‐UVB) and (b) combination of topical corticosteroid (TCS) and NB‐UVB compared to TCS for localised vitiligo. Methods: Cost‐effectiveness analysis alongside a pragmatic, 3‐arm, placebo‐controlled RCT with 9 months’ treatment. 517 Adults and children (aged ≥5 years) with active vitiligo affecting <10% of skin recruited from secondary care and community were randomised 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 QALYs using the EQ‐5D‐5L for those aged 11+ and CHU‐9D for those aged 5 to <18.ResultsMean (SD) cost per participant was £774.4 (83.71) for NB‐UVB, £813.38 (111.39) for combination treatment and £599.98 (96.18) for TCS. In analyses adjusted for age and target patch location, incremental difference in cost for combination treatment compared to TCS was £211.46 (95% CI 188.10 to 234.81), corresponding to a risk difference of 10.94% (Number‐Needed‐To‐Treat (NNT= 9). Incremental cost was £1,932.35 per successful treatment. The incremental difference in cost for NB‐UVB compared to TCS was £173.44 (95% CI 150.55 to 196.32) with a risk difference of 5.20% (NNT=19). Incremental cost was £3,335.74 per successful treatment. Conclusion: Combination treatment, compared to 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 £1,932 per additional treatment success.

Item Type: Article
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: LivePure Connector
Date Deposited: 18 Sep 2020 00:31
Last Modified: 22 Oct 2020 23:59
URI: https://ueaeprints.uea.ac.uk/id/eprint/76928
DOI: 10.1111/bjd.19554

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