The economic impact of intermittent high-dose intravenous versus oral corticosteroid treatment of juvenile dermatomyositis

Objective. To perform a cost-identification and cost-effectiveness analysis comparing oral corticosteroids (OCS) with high-dose intermittent intraveno us corticosteroid (IVCS) regimens in the treatment of juvenile dermatomyosi tis (JDM). Methods. Children previously diagnosed and treated for JDM (without myositi s-specific or myositis-associated autoantibodies) at a single medical cente r by a single provider were identified. Two treatment protocols were compar ed: OCS and IVCS. Data on initial disease severity time to remission, resou rce use, and costs generated were collected from patient records. Increment al cost-effectiveness ratios (ICE) ere constructed. Results. Patients treated with IVCS achieved median remission 2 years earli er at median increased cost of $13,736. The ICE ratio comparing IVCS to OCS is $6,868 per year of disease avoided. Conclusion. This study suggests that, although IVCS treatments are costly, they are cost-effective.