The Price for Treatment of Chronic Skin Diseases: Different Approaches

Fluhr, Joachim W.; Jünger, Michael

doi:10.1159/000096905

Cited by 6 publications

(3 citation statements)

References 11 publications

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“…In the US, moderate to severe psoriasis is mostly treated in an outpatient setting [7,8], while in Germany and other European countries inpatient treatment, mostly conducted as a regimen of topical dithranol combined with UV light, still is a common, but expensive therapeutic alternative [9–12]. However, this regimen is increasingly being replaced by highly effective outpatient alternatives, in particular by biologicals [4,13–16]. …”

Section: Introductionmentioning

confidence: 99%

Cost-of-Illness in Psoriasis: Comparing Inpatient and Outpatient Therapy

et al. 2013

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Treatment modalities of chronic plaque psoriasis have dramatically changed over the past ten years with a still continuing shift from inpatient to outpatient treatment. This development is mainly caused by outpatient availability of highly efficient and relatively well-tolerated systemic treatments, in particular BioLogicals. In addition, inpatient treatment is time- and cost-intense, conflicting with the actual burst of health expenses and with patient preferences. Nevertheless, inpatient treatment with dithranol and UV light still is a major mainstay of psoriasis treatment in Germany. The current study aims at comparing the total costs of inpatient treatment and outpatient follow-up to mere outpatient therapy with different modalities (topical treatment, phototherapy, classic systemic therapy or BioLogicals) over a period of 12 months. To this end, a retrospective cost-of-illness study was conducted on 120 patients treated at the University Medical Centre Mannheim between 2005 and 2006. Inpatient therapy caused significantly higher direct medical, indirect and total annual costs than outpatient treatment (13,042 € versus 2,984 €). Its strong influence on cost levels was confirmed by regression analysis, with total costs rising by 104.3% in case of inpatient treatment. Patients receiving BioLogicals produced the overall highest costs, whereas outpatient treatment with classic systemic antipsoriatic medications was less cost-intense than other alternatives.

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Section: Introductionmentioning

confidence: 99%

Cost-of-Illness in Psoriasis: Comparing Inpatient and Outpatient Therapy

et al. 2013

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“…In the US, moderate to severe psoriasis is mostly treated in an outpatient setting [7,8], while in Germany and other European countries inpatient treatment, mostly conducted as a regimen of topical dithranol combined with UV light, still is a common, but expensive therapeutic alternative [9][10][11][12]. However, this regimen is increasingly being replaced by highly effective outpatient alternatives, in particular by biologicals [4,[13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Correction: Cost-of-Illness in Psoriasis: Comparing Inpatient and Outpatient Therapy

Steinke¹,

Peitsch²,

Ludwig³

et al. 2014

PLoS ONE

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Treatment modalities of chronic plaque psoriasis have dramatically changed over the past ten years with a still continuing shift from inpatient to outpatient treatment. This development is mainly caused by outpatient availability of highly efficient and relatively well-tolerated systemic treatments, in particular BioLogicals. In addition, inpatient treatment is time-and cost-intense, conflicting with the actual burst of health expenses and with patient preferences. Nevertheless, inpatient treatment with dithranol and UV light still is a major mainstay of psoriasis treatment in Germany. The current study aims at comparing the total costs of inpatient treatment and outpatient follow-up to mere outpatient therapy with different modalities (topical treatment, phototherapy, classic systemic therapy or BioLogicals) over a period of 12 months. To this end, a retrospective cost-of-illness study was conducted on 120 patients treated at the University Medical Centre Mannheim between 2005 and 2006. Inpatient therapy caused significantly higher direct medical, indirect and total annual costs than outpatient treatment (13,042 € versus 2,984 €). Its strong influence on cost levels was confirmed by regression analysis, with total costs rising by 104.3% in case of inpatient treatment. Patients receiving BioLogicals produced the overall highest costs, whereas outpatient treatment with classic systemic antipsoriatic medications was less cost-intense than other alternatives.

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“…Often there is reluctance to prescribe adequate quantities and duration of treatment, even if the severity of the dermatitis and the degree of body surface involvement indicate such an approach. A heightened degree of worry and strong feelings of “steroid phobia” are encountered commonly in parents as well (13–16).…”

mentioning

confidence: 99%

Fluocinolone Acetonide 0.01% in Peanut Oil: Safety and Efficacy Data in the Treatment of Childhood Atopic Dermatitis in Infants as Young as 3 Months of Age

Dohil

Alvarez‐Connelly

Eichenfield

2009

Pediatric Dermatology

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Fluocinolone acetonide 0.01% in a blend of refined peanut and mineral oils has been established as effective and safe treatment for atopic dermatitis in patients 2 years and older, including those with peanut sensitivity, for several years. We sought to study the safety of fluocinolone acetonide 0.01% oil and its potential for adrenal axis suppression in infants as young as 3 months of age. A controlled, open-label study was performed in children aged 3 months to 2 years with moderate to severe atopic dermatitis at two academic pediatric dermatology centers. Patients received topical fluocinolone acetonide 0.01% oil twice daily to affected areas involving a minimum of 20% body surface ratio for 4 weeks. Cortisol stimulation testing was performed at baseline and at the end of the treatment phase. Patients were monitored for medication use and adverse events. Efficacy was assessed using the Investigator Global Severity and Response scales. Thirty-two patients with moderate to severe atopic dermatitis were recruited into the study and 30 were evaluated with the Physician's Global Improvement Assessment tool. The mean body surface ratio treated for all age groups was 48%. Eighty-three percent of patients had marked or better improvement scores by week 2 and 96% by week 4, with 40% completely cleared. No adrenal suppression occurred in the 24 patients that met inclusion criteria for hypothalamus-pituitary axis (HPA) axis analysis. No relevant adverse events occurred. Results of this study support the safety and efficacy of fluocinolone acetonide 0.01% in refined peanut oil vehicle, for infants as young as 3 months of age with atopic dermatitis. No evidence of adrenal suppression or adverse local effects was demonstrated after 4 weeks of twice daily treatment.

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The Price for Treatment of Chronic Skin Diseases: Different Approaches

Cited by 6 publications

References 11 publications

Cost-of-Illness in Psoriasis: Comparing Inpatient and Outpatient Therapy

Cost-of-Illness in Psoriasis: Comparing Inpatient and Outpatient Therapy

Correction: Cost-of-Illness in Psoriasis: Comparing Inpatient and Outpatient Therapy

Fluocinolone Acetonide 0.01% in Peanut Oil: Safety and Efficacy Data in the Treatment of Childhood Atopic Dermatitis in Infants as Young as 3 Months of Age

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