Effect of Methoxsalen Photochemotherapy on Cost of Treatment for Psoriasis
An Example of Technological Assessment
- Robert S. Stern, MD;
- Lawrence A. Thibodeau, PhD;
- Ruth A. Kleinerman, MPH;
- John A. Parrish, MD;
- Thomas B. Fitzpatrick, MD;
- Howard L. Bleich, MD
- From the Departments of Dermatology, Massachusetts General Hospital, Beth Israel Hospital, and Harvard Medical School (Drs Stern, Parrish, and Fitzpatrick, and Ms Kleinerman), the Center for the Analysis of Health Practices (Drs Stern and Thibodeau) and Department of Biostatistics (Dr Thibodeau), Harvard School of Public Health, and the Computer Medicine Laboratory (Dr Bleich) and Department of Medicine (Drs Stern and Bleich), Beth Israel Hospital and Harvard Medical School, Boston.
Abstract
In 1974 a new therapy that employs methoxsalen and ultraviolet A irradiation (PUVA) was introduced as an outpatient treatment for severe psoriasis. To study the effect of this therapy on the cost of treatment, we documented for 1,320 patients two major components of cost—hospitalization and PUVA treatments. When the one-year period before initiation of PUVA therapy was compared with a one-year period after initiation of PUVA therapy, average hospital days per person per year declined 77% (5.1 vs 1.2). This decrease in hospitalization was most notable among patients who continued to use PUVA therapy. Largely offsetting the reduction in cost from reduced hospitalization was the cost of PUVA treatments. Our data confirm the previously known effectiveness of PUVA therapy, and they provide no support for the hypothesis that PUVA substantially increases the cost of treating patients with severe psoriasis.
(JAMA 1981;245:1913-1918)
Footnotes
-
Reprint requests to Department of Dermatology, Beth Israel Hospital, 330 Brookline Ave, Boston (Dr Stern).
