Narrowband - UVB (NB-UVB) treatment for psoriasis is considered expensive. However, existing data are based on estimates and do not consider indirect cost savings.
To define actual costs of NB-UVB incurred by the service provider, as well as treatment-associated cost savings.
Data linkage of (i) comprehensive treatment records, (ii) prescribing data for all NB-UVB treatment episodes spanning six years in a population of 420,000. Minimisation of data fluctation by: (a) compiling data from 4 independent treatment sites, (b) use of drug prescribing unrelated to psoriasis as negative control.
NHS Tayside spent an average of £257 per NB-UVB treatment course (£257 ± 63; range 150 - 286 across four independent treatment sites), contrasting sharply with the estimate of £1882 used by NICE UK. The cost of topical treatments averaged £128 per patient in the 12-months prior to NB-UVB, accounting for 42% of overall drug costs incurred by these patients. This was reduced by 40% to £53 per patient over the 12 month period following NB-UVB treatment while psoriasis unrelated drug-prescribing remained unchanged, suggesting disase-specific effects of NB-UVB. Data were not due to site-specific factors as confirmed by highly similar results observed between treatment sites operated by distinct staff. Finally, we detail all staff hours directly and indirectly involved in treatment, allowing direct translation of cost into other health care systems.
NB-UVB is a low-cost treatment; cost figures currently used in health technology appraisals are an overestimate based on the data presented here. Creating or extending access to NB-UVB is likely to offer additional savings by delaying or avoiding costly third line treatments for many patients. This article is protected by copyright. All rights reserved.