betamethasone valerate 2.25mg medicated plaster (Betesil)

following a full submission

betamethasone valerate medicated plaster (Betesil) is not recommended for use within NHS Scotland.

Indication under review: Treatment of inflammatory skin disorders which do not respond to treatment with less potent corticosteroids, such as eczema, lichenification, lichen planus, granuloma annulare, palmoplantar pustulosis and mycosis fungoides.  Due to its particular pharmaceutical form, betamethasone medicated plaster is suitable for chronic plaque psoriasis localized in difficult to treat areas (e.g. knees, elbows and anterior face of the tibia on an area not greater than 5% of the body surface).

In phase III studies in patients with mild to moderate plaque psoriasis, betamethasone medicated plaster was superior to non-occluded betamethasone cream, assessed using the psoriasis area and severity index score and psoriasis global assessment.

However, the manufacturer did not submit a sufficiently robust economic analysis to gain acceptance by SMC.