Exploring the health economics of community phototherapy

Organisation/institution: CHEME at Bangor University and BCUHB dermatology services at Ysbyty Gwynedd

Key contact: Dr Hani Ismail, MRes Health Economics, CHEME, Bangor University

What was the question that we could help with?

Fifty-four percent of the population is affected by chronic skin disease in a given year and there has been a 35% rise in new outpatient activity over 10 years. West BCUHB expenditure is growing every year, thought to be due to over-spending on drug treatments. Phototherapy uses ultraviolet (UVB) rays to effectively treat skin conditions, such as psoriasis, and is predominantly a hospital-based treatment. It has been shown to clear psoriasis in 80-90% of patients. Phototherapy requires three times weekly visits, which many patients find difficult to attend due to poor access to phototherapy units. To address this obstacle of accessing hospital-based phototherapy, Dr Hani Ismail, MRes Health Economics, explored the health economics of community phototherapy by conducting a systematic review, qualitative research, and cost analysis. The systematic review considered the current evidence on the cost-effectiveness of home phototherapy.

What did we do?

Health and Care Economics Cymru has played an important role in bringing together Betsi Cadwaladr University Health Board (BCUHB) dermatology services at Ysbyty Gwynedd and staff at the Centre for Health Economics and Medicines Evaluation (CHEME) at Bangor University to offer an MRes training experience for Dr Hani Ismail, an F1 medical student, to explore the economics of community light box therapy in rural North Wales.

What is the expected impact?

Dr Hani Ismail found home phototherapy to be more cost-effective or less costly with similar outcomes compared to hospital-based phototherapy. The qualitative research used semi-structured interviews to explore patient, staff and carer experience in community phototherapy. The cost analysis examined the cost of a course of home phototherapy and hospital-based phototherapy.

We anticipate a peer-reviewed academic paper from this research as well as BCUHB report on the potential cost-savings to the NHS of a community light box therapy service with the potential to reduce high-cost prescribing of biologic drugs across North Wales.

This study has potential for highlighting alternatives to high-cost new drugs in the treatment of dermatological treatments, aligned with the value-based health care agenda.