Review Article
Psoriasis treatment and management – a systematic review of full economic evaluations
M.P. Hamilton,
D. Ntais,
C.E.M. Griffiths,
L.M. Davies,
on behalf of
Corresponding Author
M.P. Hamilton
Centre for Health Economics, University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL U.K
Correspondence
Matthew P. Hamilton.
E-mail: [email protected]
Search for more papers by this authorD. Ntais
Centre for Health Economics, University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL U.K
Search for more papers by this authorC.E.M. Griffiths
Centre for Dermatology Research, University of Manchester, Manchester Academic Health Science Centre, Manchester, U.K
Salford Royal NHS Foundation Trust, University of Manchester, Manchester Academic Health Science Centre, Manchester, U.K
Search for more papers by this authorL.M. Davies
Centre for Health Economics, University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL U.K
Search for more papers by this authorM.P. Hamilton,
D. Ntais,
C.E.M. Griffiths,
L.M. Davies,
on behalf of
Corresponding Author
M.P. Hamilton
Centre for Health Economics, University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL U.K
Correspondence
Matthew P. Hamilton.
E-mail: [email protected]
Search for more papers by this authorD. Ntais
Centre for Health Economics, University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL U.K
Search for more papers by this authorC.E.M. Griffiths
Centre for Dermatology Research, University of Manchester, Manchester Academic Health Science Centre, Manchester, U.K
Salford Royal NHS Foundation Trust, University of Manchester, Manchester Academic Health Science Centre, Manchester, U.K
Search for more papers by this authorL.M. Davies
Centre for Health Economics, University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL U.K
Search for more papers by this authorFunding sources This article presents independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research scheme (RP-PG-0608-10163). The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR or the Department of Health.
Conflicts of interest M.P.H. has received speaking and consulting fees from Leading Edge Group for a project funded by Pfizer. C.E.M.G. has received honoraria and/or research grants from Abbvie, Amgen, Galderma, Janssen, LEO, Lilly, MSD, Novartis, Pfizer, Sandoz, Trident and UCB.
Summary
Background
Psoriasis frequently requires lifetime control and current therapies vary significantly in price. High-quality economic evaluations are necessary to determine if higher-cost treatments are value for money.
Objectives
This review aims to identify the cost-effectiveness of psoriasis care (whether more expensive interventions are associated with savings in health care and psoriasis management and/or improve patients' health); assess the level of uncertainty and transferability of this evidence to policy and practice; and, identify future research needs.
Methods
Searches of electronic databases Embase, MEDLINE and NHS EED for full economic evaluations were conducted in January 2012 (updated April 2014). Included articles were screened, selected and critically appraised using predefined inclusion criteria and data extraction forms: 1355 articles were identified; 37 papers reporting 71 comparisons met the inclusion criteria. Treatments evaluated were systemic (n = 45), topical (n = 22), phototherapies (n = 14) and combination (n = 4).
Results
Despite a significant number of recent economic evaluations, the cost-effectiveness of all therapies remains unclear. This uncertainty arises from a diversity in settings, perspective and design. Economic evaluations were constrained by limited availability of high-quality short- and long-term head-to-head comparisons of the effectiveness, safety and adherence of different interventions.
Conclusions
The economic evidence is dominated by comparisons of interventions to placebo, with implicit comparisons of different therapies. There is a lack of evaluations of service model innovations to deliver complex packages of care for psoriasis. Primary and secondary integrated clinical and economic research is needed to address the limitations and to identify patient preferences and barriers/facilitators to treatment.
Supporting Information
| Filename | Description |
|---|---|
| bjd13486-sup-0001-TableS1.pdfapplication/PDF, 194.3 KB | Table S1. Summary characteristics of included studies. |
| bjd13486-sup-0002-TableS2.pdfapplication/PDF, 288.5 KB | Table S2. Treatments examined. |
| bjd13486-sup-0003-TableS3.pdfapplication/PDF, 166.7 KB | Table S3. Methodological profile of included studies. |
| bjd13486-sup-0004-TableS4.pdfapplication/PDF, 200.6 KB | Table S4. Summary information on funding sources. |
| bjd13486-sup-0005-TableS5.pdfapplication/PDF, 214 KB | Table S5. Articles including more than one comparison. |
| bjd13486-sup-0006-TableS6.pdfapplication/PDF, 90.2 KB | Table S6. Search Terms and results for database queries. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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