Cost-effectiveness analysis of tacrolimus ointment versus high-potency topical corticosteroids in adults with moderate to severe atopic dermatitis

Charles N. Ellis*, Lynn A. Drake, Mary M. Prendergast, William Abramovits, Mark Boguniewicz, C. Ralph Daniel, Mark Lebwohl, Amy Paller, Seth R. Stevens, Diane L. Whitaker-Worth, Kuo B. Tong

*Corresponding author for this work

Research output: Contribution to journalArticle

54 Scopus citations

Abstract

Background: Few cost-effectiveness analyses have been conducted on topical therapies for atopic dermatitis. Objective: We sought to compare cost-effectiveness of high-potency topical corticosteroids (HPTCs) and tacrolimus ointment for the treatment of moderate to severe atopic dermatitis for patients who are not responsive to or not well controlled with mid-potency topical corticosteroids. Methods: A Markov model represented the cyclic nature of atopic dermatitis. Clinical outcomes were derived from published literature. "Efficacy" was defined as disease-controlled days on which patients experienced a greater than 75% improvement in their disease. Resource use and changes in management were on the basis of opinions of a physician panel; secondary treatment was an oral antibiotic with topical corticosteroids. Sensitivity analyses were conducted for all variables. Results: The model was sensitive to duration of continuous treatment with HPTCs. HPTCs, when limited to 2-week treatment cycles, were associated with the highest total costs ($1682 per year) and the least efficacy (185 disease-controlled days). HPTCs in 4-week treatment intervals and tacrolimus ointment were similar in total costs and efficacy ($1317 vs $1323 for 194 vs 190 disease-controlled days, respectively). Although primary drug costs were higher for patients treated with tacrolimus ointment, patients treated with regimens of HPTCs incurred higher secondary drug costs. Conclusion: In the base case analyses, tacrolimus ointment was more cost-effective than HPTCs administered in 2-week treatment cycles, and similar in cost-effectiveness to 4-week cycles of HPTCs.

Original languageEnglish (US)
Pages (from-to)553-563
Number of pages11
JournalJournal of the American Academy of Dermatology
Volume48
Issue number4
DOIs
StatePublished - Apr 1 2003

ASJC Scopus subject areas

  • Dermatology

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