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, T H Thomas, K S Batchelor, J M Perways, A Chalmers, J R Haines, R H Meakin, G D Duley, L Ravenscroft, J C Rogers, A
Sach, T H
Thomas, K S
Batchelor, J M
Perways, A
Chalmers, J R
Haines, R H
Meakin, G D
Duley, L
Ravenscroft, J C
Rogers, A
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.
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Date
2020-11-04
Type
Article
Other
Other
Subject
Paediatrics
Collections
Citation
Sach TH, Thomas KS, Batchelor JM, Perways A, Chalmers JR, Haines RH, Meakin GD, Duley L, Ravenscroft JC, Rogers A, Santer M, Tan W, White J, Whitton ME, Williams HC, Cheung ST, Hamad H, Wright A, Ingram JR, Levell N, Goulding JMR, Makrygeorgou A, Bewley A, Ogboli M, Stainforth J, Ferguson A, Laguda B, Wahie S, Ellis R, Azad J, Rajasekaran A, Eleftheriadou V, Montgomery AA; UK Dermatology Clinical Trials Network’s HI-Light Vitiligo Trial Team. 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). Br J Dermatol. 2021 May;184(5):840-848. doi: 10.1111/bjd.19554. Epub 2020 Nov 4
Journal / Source Title
The British Journal of Dermatology
DOI
10.1111/bjd.19554
PMID
32920824
Publisher
Oxford University Press
Publisher’s URL
http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1365-2133