Economic Impact of Home-Use versus Office-Use Diphenylcyclopropenone in Extensive Alopecia Areata

Abstract

Introduction: Diphenylcyclopropenone (DPCP) is the medication of choice for the treatment of severe alopecia areata (AA) according to AA treatment guidelines. Precise initiation and application are important factors for successful treatment. However, it is difficult for patients who live far away to visit their doctor weekly. Methods: We conducted a retrospective cohort study to assess the cost, effectiveness, and side effects of DPCP treatment between office-use DPCP (O-DPCP) and home-use DPCP (H-DPCP) in severe AA patients. A cost-effectiveness analysis was performed from the perspective of healthcare providers and patients using real-world data and the national cost statistics for hospital services comparing O-DPCP and H-DPCP in patients with severe AA at 24, 36, and 48 weeks. Results: Two groups of 41 patients treated with O-DPCP and H-DPCP were enrolled. There was no significant difference in the proportion of patients who showed a favorable outcome (≥50% improvement) with minimal side effects between both groups at 24 (O-DPCP 43.9% vs. H-DPCP 26.8%, p = 0.11), 36 (O-DPCP 58.5% vs. H-DPCP 43.9%, p = 0.19), or 48 weeks (O-DPCP 63.4% vs. H-DPCP 56.1%, p = 0.49). The cost of H-DPCP was half of the cost of O-DPCP. Discussion/Conclusion: H-DPCP is a cost-effective and time-efficient alternative treatment option for severe AA patients.