OBJECTIVES: The aim of this study was to determine the cost-effectiveness of Enstilar® compared to the Standard of Care in treating patients with psoriasis vulgaris. Enstilar® is a fixed combination foam (calcipotriene and betamethasone dipropionate) approved for the treatment of psoriasis vulgaris in adult patients. The Standard of Care is Dovobet® Gel, indicated for the topical treatment of mild to moderate psoriasis.

METHODS: A decision-tree model was used to compare costs and effects of Enstilar® and Dovobet® Gel using the Italian National Healthcare Service perspective. The time horizon used in this simulation is one year, it was deemed sufficient to evaluate cost and results of both therapies. Efficacy and length of treatment cycle for the two therapies were determined using a head to head study. The utility is expressed in terms of QALYs for the two health states considered (patients respond to treatment or not) and was derived from published data. Results are presented in terms of incremental cost per quality-adjusted life years gained. Probabilistic sensitivity analysis was conducted using Monte Carlo simulation.

RESULTS: The Incremental Cost-Effectiveness Ratio (ICER) for Enstilar® compared to Dovobet® Gel is -117,75 €. Indeed, the introduction of Enstilar® reduces the cost per cycle (83,86 € compared to 91,86 € with Dovobet® Gel) and increase the efficacy (PGA of 38,3% with Enstilar® Vs 22,5% with Dovobet® Gel). The sensitivity analysis confirmed these results showing an average ICER of -106,92€ with a standard deviation of 217,35€.

CONCLUSIONS: The present study indicates that Enstilar® is Dominant compared to the standard of care (Dovobet® Gel). The sensitivity analysis demonstrates that in the 72% of the 1.000 simulations conducted Enstilar® is still dominant and that in the 88% of the simulations the ICER falls below the maximum acceptable ceiling ratio, fixed equal to the Dovobet® Gel cost per cycle.