Narrowband ultraviolet B treatment for psoriasis is highly economical and causes significant savings in cost for topical treatments

Boswell, K.; Cameron, H.; West, Jonathan; Fleming, Colin; Ibbotson, S.H.; Dawe, Robert; Foerster, John

doi:10.1111/bjd.16716

Cited by 23 publications

(28 citation statements)

References 27 publications

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“…UVB was introduced into increasingly widespread and routine use following developmental work in the 1980s ( 8 – 11 ). NB-UVB phototherapy reduces the need for topical therapies ( 1 ) and is a cost effective ( 12 ) and safe treatment, which involves repeated controlled delivery of the narrowband region of the UVB spectrum centered on 311 nm ( 4 , 6 ). The main acute adverse effects of NB-UVB are erythema and induction of photosensitivity diseases, such as polymorphic light eruption (PLE).…”

Section: Introductionmentioning

confidence: 99%

A Perspective on the Use of NB-UVB Phototherapy vs. PUVA Photochemotherapy

Ibbotson

2018

Front. Med.

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Narrowband UVB (NB-UVB) phototherapy and psoralen-UVA (PUVA) photochemotherapy are widely used phototherapeutic modalities for a range of skin diseases. The main indication for NB-UVB and PUVA therapies is psoriasis, and other key diagnoses include atopic eczema, vitiligo, cutaneous T-cell lymphoma (CTCL), and the photodermatoses. The decision on choice of phototherapy is important and NB-UVB is usually the primary choice. NB-UVB phototherapy is a safe and effective therapy which is usually considered when topical agents have failed. PUVA requires prior psoralen sensitization but remains a highly effective mainstay therapy, often used when NB-UVB fails, there is rapid relapse following NB-UVB or in specific indications, such as pustular or erythrodermic psoriasis. This review will provide a perspective on the main indications for use of NB-UVB and PUVA therapies and provide comparative information on these important dermatological treatments.

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Section: Introductionmentioning

confidence: 99%

A Perspective on the Use of NB-UVB Phototherapy vs. PUVA Photochemotherapy

Ibbotson

2018

Front. Med.

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“…Numbers of treated patients were ascertained from the PhotoSys database, as previously described . The cost of NB‐UVB phototherapy has been detailed recently . The cost of one course of PUVA incurred by NHS Tayside has been calculated as follows: The number of staff hours, estate cost, technician, supervision, admin etc detailed in Reference (Tables S2‐S6 therein) is identical between NB‐UVB and PUVA, respectively.…”

Section: Methodsmentioning

confidence: 99%

“…To address this knowledge gap, we recently undertook detailed efficacy analysis under real‐world conditions using methodology to minimize reporting and selection bias . Using long‐term comprehensive data from a healthcare provider in Scotland (NHS Tayside), we subsequently presented detailed cost figures, showing that this provider had incurred an average cost of £257 ± 64 per completed course over the course of 6 years . This figure included both direct costs (job plan allocations, support staff), as well as an exhaustive list of indirect cost (pension contributions, administration, estate, depreciation, etc), and data were obtained from four independently operated sites, thereby minimizing random effects attributable to site‐specific cost efficiency.…”

Section: Introductionmentioning

confidence: 99%

Phototherapy achieves significant cost savings by the delay of drug‐based treatment in psoriasis

Foerster

Dawe

2019

Photoderm Photoimm Photomed

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Background Although used for decades in psoriasis, access to phototherapy is becoming increasingly restricted. Besides patient inconvenience, this is in large part to do with a perception of “high cost.” We previously reported a comprehensive analysis of direct and indirect phototherapy treatment cost. However, no robust data exist on the actual savings associated with providing phototherapy in the treatment pathway. Objectives To quantify the cost savings achieved by phototherapy by delaying alternative treatments. Methods Costs accruing through the UK‐wide established treatment pathway with and without phototherapy were analysed. Direct and indirectly incurred drug treatment costs were calculated using drug tariff, laboratory cost, estate rates and clinic review costs. To enhance reliability, ranges of cost scenarios were calculated by varying parameters such as drug dosing. Results Medium annual cost savings per patient were £2200 [range: £1800‐£2900] for NB‐UVB, and £3700 [range: £2500‐£5300] if both NB‐UVB and PUVA courses were administered, respectively. As the provider treated 656 ± 76 patients per year during the 6‐year observational window, this amounted to savings of £Mio 2.4 [range: £Mio 1.6‐£Mio 3.4], even excluding additional non‐modelled drug‐associated costs (eg diagnostics, adverse event management). Since we only consider cost savings by delay of drug treatment for the duration of phototherapy, drug price reductions through biosimilar introduction only have a small effect. We provide spreadsheets allowing adaptation cost savings projections by varying input variables. Conclusions Healthcare providers may achieve significant cost savings by implementing and/or widening access to phototherapy.

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“…published in this issue of the BJD addresses this important issue by assessing direct and indirect costs incurred for NB‐UVB treatment of psoriasis by a healthcare provider (NHS Tayside, Scotland) . Furthermore, phototherapy‐related cost‐savings because of the reduced need for topical psoriasis treatment were also analysed . The authors calculated a cost of £257 for a NB‐UVB treatment course (averaging 30 NB‐UVB sessions and equating to £8·50 per session) and a saving of £53 in topical treatment.…”

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confidence: 99%

“…10 Furthermore, phototherapy-related cost-savings because of the reduced need for topical psoriasis treatment were also analysed. 10 The authors calculated a cost of £257 for a NB-UVB treatment course (averaging 30 NB-UVB sessions and equating to £8Á50 per session) and a saving of £53 in topical treatment. With a net average cost of £204 per treatment course, NB-UVB is a highly cost-effective treatment option for psoriasis.…”

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confidence: 99%