According to a new study, researchers determined that treating severe skin conditions with UV light rather than creams, pills, and injections could save the NHS millions of pounds while improving patient outcomes. The study was published in British Journal of Dermatology.
Researchers found the annual per-patient cost of filtered UV light treatment, known as phototherapy, to be around £250. This is one-sixth of the cost attributed to phototherapy by the National Institute for Health and Care Excellence (NICE) and a fraction of the estimated £7-12,000 annual cost of injectable biologic therapies.
Steroid creams are frequently prescribed for skin diseases but these can cause serious side effects and can prove inadequate to bring diseases such as psoriasis and eczema under control. Patients may then be referred for more intensive treatment, which could include pills, injections or phototherapy.
If phototherapy had not been available in the NHS Tayside area, alternative drug-based treatments would have cost the health board an extra £3353 per patient each year. ,They predict that any health board that does not offer sufficient access to phototherapy at present has a real chance of saving more than £1million per year by improving availability.
Despite this, the researchers believe misconceptions about the cost of delivering phototherapy and its efficacy mean that healthcare providers are reluctant to increase availability, with many areas across the UK being poorly served by phototherapy facilities.
UV light treatment is effective, is less invasive and has fewer side effects than alternative therapies, and can deliver massive cost savings. Facilities must be maintained by trained staff who also administer the treatment and there is an assumption that staff-intensive means expensive but that's not the case.
For each treatment, the staff time is minimal and, for this treatment, it's 'the more, the cheaper,' which is the exact opposite of drug treatments where it is 'the more, the dearer.' Each treatment only takes up a very small percentage of the staff members' overall workload compared to how many treatments are given out.
Phototherapy involves safe, controlled delivery of narrow wavebands of ultraviolet radiation in specially constructed cabins. The Dundee team had previously shown that three-quarters of patients experienced significant improvements after phototherapy and that 25% reduced the need for steroid creams.
Researchers examined the costs involved in delivering phototherapy at sites in the city, large town, small town and rural settings. In addition to breaking down the staff costs of those delivering the treatment, they also factored in expenses relating to administration, training, pensions, medical physics, equipment, depreciation and consultant supervision.
Set-up costs in areas where phototherapy is not currently available are something we also considered. They looked here at how much it costs to implement this service on both a large and relatively small-scale basis.
When NICE assess new therapies, they look at not just how beneficial these are to patients but also how economical they are. The NICE appraisal puts the cost of phototherapy at £1800 per treatment. Our data will require this to be corrected, which we hope will have positive implications for sufferers of skin diseases.