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, T H, Thomas, K S, Batchelor, J M, Akram, P, Chalmers, J R, Haines, R H, Meakin, G D, Duley, L, 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, N, 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). The British journal of dermatology. ISSN 1365-2133.

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Official URL: https://onlinelibrary.wiley.com/doi/10.1111/bjd.19...

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.

RESULTS

Mean (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
Subjects: WR Skin. Dermatology
Divisions: Ambulatory Care > Dermatology
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Depositing User: Mrs Caroline Tranter
Date Deposited: 22 Sep 2020 10:58
Last Modified: 22 Sep 2020 10:58
URI: http://www.repository.uhblibrary.co.uk/id/eprint/3455

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