Harvard Women's Health Watch

Update: Home phototherapy for psoriasis is cost-effective

In our article about psoriasis in the June 2010 issue of Harvard Women's Health Watch ("Bringing psoriasis under control"), we mentioned phototherapy using ultraviolet B (UVB), a treatment that usually requires 30 sessions at a hospital or clinic. We noted that home therapy systems are available but did not compare them with clinic-based treatment. Now, a Dutch study in the medical journal BMJ (May 1, 2010) has found that home phototherapy devices are as cost-effective as hospital-based treatment. An earlier study by the same group had shown that home phototherapy is at least as safe and effective as conventional outpatient phototherapy. The study involved about 200 people with psoriasis randomly assigned to receive phototherapy at home or at a hospital.

At the end of treatment, costs were roughly equal: $950 for hospital-based sessions and $1,000 for home devices (these were rented from home care organizations). Therapeutic benefits were also similar: 82% of the home therapy patients and 79% of the patients treated at a hospital showed an improvement of 50% or more. Most patients in both groups said they would prefer home phototherapy if they needed treatment again in the future.

If you're interested in using a home UVB device for psoriasis treatment, check with your health plan. These devices usually aren't available for rent. Purchase requires a doctor's prescription, and the cost can range from $600 for a handheld unit (to spot-treat small areas of the body) to $2,000 and up for a whole-body unit. Some insurers reimburse all or part of the cost, but criteria for reimbursement vary widely.

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