Per-Gram Cost of Medication is by Itself a Poor Indicator for Comparing Costs of Different Psoriasis Treatments: A Retrospective Cohort Study of the Cost of Psoriasis Treatment with Topical Corticosteroids versus Topical Calcipotriene

Abstract

Background: New treatments are available for psoriasis that complement or replace the use of topical corticosteroids. Objective: The purpose of this article is to assess the relative overall cost difference between regimens based on topical steroids and those using the nonsteroidal antipsoriasis medication, topical calcipotriene. Methods: Retrospective data on the cost of therapy of psoriasis were attained through analysis of claims from a national pharmaceutical-and-medical-visit claims-database. Episodes of psoriasis treatment were defined and analyzed for patients whose therapy was initiated with either topical calcipotriene or topical corticosteroids of different potency classes. Results: The average medication cost per episode was greater for topical calcipotriene ($111/episode) compared to ultrahigh potency ($70/episode), high potency ($57/episode), mid potency ($47/episode), and low-potency, ($75/episode) topical corticosteroids (p < .05). The average total cost of therapy for the topical calcipotriene regimen ($218) fell within the range for the cost of therapy for topical steroid base regimens ($197 to $457); there were no significant differences in the total cost of therapy between topical calcipotriene monotherapy and other treatment groups. Conclusion: The per-gram cost of medication is by itself a poor indicator for comparing the cost of different psoriasis treatment regimens. Given the greater safety and efficacy of combination regimens in terms of both short-term improvement and long-term control, initiating psoriasis treatment with a combination regimen of topical calcipotriene combined with an ultrapotent corticosteroid appears to be the most cost-effective approach to psoriasis treatment.