Cost-Effectiveness of Delgocitinib vs. PUVA in Patients With Moderate-to-Severe Chronic Hand Eczema
Author(s)
Ryan Pulleyblank, PhD1, Nanna Nyholm, MSc1, Rie von Eyben, MSc1, Jeanne Armand, MSc2, Laura Sawyer, MSc2, Andrew Pink, PhD3, Michael Cork, MD, PhD4.
1LEO Pharma A/S, Ballerup, Denmark, 2Symmetron Ltd, London, United Kingdom, 3Guy’s and St. Thomas NHS Foundation Trust, London, United Kingdom, 4Sheffield Dermatology Research, Division of Clinical Medicine, School of Medicine & Population Health, The University of Sheffield Medical School, Sheffield, United Kingdom.
1LEO Pharma A/S, Ballerup, Denmark, 2Symmetron Ltd, London, United Kingdom, 3Guy’s and St. Thomas NHS Foundation Trust, London, United Kingdom, 4Sheffield Dermatology Research, Division of Clinical Medicine, School of Medicine & Population Health, The University of Sheffield Medical School, Sheffield, United Kingdom.
OBJECTIVES: Delgocitinib cream and psoralen with ultraviolet A (PUVA) light therapy are treatment options for patients with moderate or severe Chronic Hand Eczema (CHE) which has not adequately responded to treatment with topical corticosteroids. This analysis investigated the relative cost-effectiveness of these treatment options in the UK.
METHODS: A Markov model was built to assess the cost-effectiveness of delgocitinib and PUVA from a UK national healthcare system perspective, based around health states defined by the investigator’s global assessment for chronic hand eczema (IGA-CHE) scale. A 10-year time horizon was considered over 4-weekly cycles, applying 3.5% discount rates for costs and quality-adjusted life years (QALYs). Efficacy and utility evidence for delgocitinib were derived from the DELTA 1, DELTA 2 clinical trials versus vehicle cream, and DELTA FORCE clinical trial versus alitretinoin. Relative efficacy evidence was provided from a network meta-analysis which included the ALPHA trial which provided for evidence of the efficacy of PUVA versus alitretinoin. A burden of illness study provided evidence on healthcare resource use.
RESULTS: Treatment with PUVA was estimated to result in 5.288 QALYs at a cost to the UK NHS of £10,335. Treatment with delgocitinib was estimated to result in 5.362 QALYs at a cost of £9,653. Key factors driving modelled cost-effectiveness results included probabilities of relapse, estimated utilities of health states, consumption of delgocitinib, response to re-treatment, risks of treatment discontinuation. A wide range of scenario analyses were conducted which were consistent with the base case findings of simultaneously greater efficacy and lower costs for treatment with delgocitinib in comparison with PUVA.
CONCLUSIONS: For treatment of patients with moderate-to-severe CHE which is inadequately treated by topical corticosteroids, delgocitinib cream provides both better clinical outcomes and lower costs for the healthcare payer in comparison with PUVA in the UK healthcare context.
METHODS: A Markov model was built to assess the cost-effectiveness of delgocitinib and PUVA from a UK national healthcare system perspective, based around health states defined by the investigator’s global assessment for chronic hand eczema (IGA-CHE) scale. A 10-year time horizon was considered over 4-weekly cycles, applying 3.5% discount rates for costs and quality-adjusted life years (QALYs). Efficacy and utility evidence for delgocitinib were derived from the DELTA 1, DELTA 2 clinical trials versus vehicle cream, and DELTA FORCE clinical trial versus alitretinoin. Relative efficacy evidence was provided from a network meta-analysis which included the ALPHA trial which provided for evidence of the efficacy of PUVA versus alitretinoin. A burden of illness study provided evidence on healthcare resource use.
RESULTS: Treatment with PUVA was estimated to result in 5.288 QALYs at a cost to the UK NHS of £10,335. Treatment with delgocitinib was estimated to result in 5.362 QALYs at a cost of £9,653. Key factors driving modelled cost-effectiveness results included probabilities of relapse, estimated utilities of health states, consumption of delgocitinib, response to re-treatment, risks of treatment discontinuation. A wide range of scenario analyses were conducted which were consistent with the base case findings of simultaneously greater efficacy and lower costs for treatment with delgocitinib in comparison with PUVA.
CONCLUSIONS: For treatment of patients with moderate-to-severe CHE which is inadequately treated by topical corticosteroids, delgocitinib cream provides both better clinical outcomes and lower costs for the healthcare payer in comparison with PUVA in the UK healthcare context.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE244
Topic
Economic Evaluation, Health Technology Assessment
Disease
Sensory System Disorders (Ear, Eye, Dental, Skin)