Cost-effectiveness analysis of topical treatments for actinic keratosis in the perspective of the Italian health care system

G. L. Colombo, S. Chimentp, S. D I Matteo, M. C. Fargnoli, P. Frascione, V. Silipo, K. Peris

Research output: Contribution to journalArticle

Abstract

Actinie keratosis (AK) is the most common cutaneous malignant neoplasm and its prevalence continues to increase. According to the most recent findings, AK is currently considered the initial stage, in situ, of squamous cell carcinoma. Field-directed therapies for AKs are the preferred treatment since they have the advantage to clear the clinically visible lesions and also subclinical lesions within the cancerous field. We assessed the cost-effectiveness of topical treatments for AKs including 3% diclofenac in 2.5% hyaluronic acid (HA) gel, imiquimod 5% cream and photodynamic therapy with methyl aminolevulinate (MAL-PDT) in the perspective of the Italian Health Care System (SSN). We used a decision tree analytical approach and efficacy data were drawn from published clinical trials. Cost was evaluated from the SSN perspective during a time horizon of 3 months. A responder was defined as a patient with all lesions clinically cleared and showing an excellent cosmetic result. Based on the applied model, the cost per complete responder was calculated. Diclofenac 3% in HA was less expensive (€ 256) than MAL-PDT (€ 320) and imiquimod (€ 342). Effectiveness was similar and better for diclofenac 3% in HA and MAL-PDT (0.813%) in comparison to 0.734% of imiquimod, respectively. The one-way and probabilistic sensitivity analyses confirmed the results of base case scenario. Based on this cost-effectiveness model, diclofenac 3% in HA can be considered the treatment of choice for AK lesions and surrounding field under a pharmacoeconomic point of view.

Original languageEnglish
Pages (from-to)573-581
Number of pages9
JournalGiornale Italiano di Dermatologia e Venereologia
Volume145
Issue number5
Publication statusPublished - 2010

Fingerprint

imiquimod
Actinic Keratosis
Diclofenac
Hyaluronic Acid
Keratosis
Cost-Benefit Analysis
Delivery of Health Care
Costs and Cost Analysis
Pharmaceutical Economics
Decision Trees
Photochemotherapy
Skin Neoplasms
Therapeutics
Cosmetics
Squamous Cell Carcinoma
Gels
Clinical Trials
1-phenyl-3,3-dimethyltriazene

Keywords

  • Actinic
  • Cost-benefit analysis
  • Healt care costs
  • Keratosis

ASJC Scopus subject areas

  • Dermatology

Cite this

Cost-effectiveness analysis of topical treatments for actinic keratosis in the perspective of the Italian health care system. / Colombo, G. L.; Chimentp, S.; Matteo, S. D I; Fargnoli, M. C.; Frascione, P.; Silipo, V.; Peris, K.

In: Giornale Italiano di Dermatologia e Venereologia, Vol. 145, No. 5, 2010, p. 573-581.

Research output: Contribution to journalArticle

@article{e19f5c46c1ab4ff09a03f4abba0c22fc,
title = "Cost-effectiveness analysis of topical treatments for actinic keratosis in the perspective of the Italian health care system",
abstract = "Actinie keratosis (AK) is the most common cutaneous malignant neoplasm and its prevalence continues to increase. According to the most recent findings, AK is currently considered the initial stage, in situ, of squamous cell carcinoma. Field-directed therapies for AKs are the preferred treatment since they have the advantage to clear the clinically visible lesions and also subclinical lesions within the cancerous field. We assessed the cost-effectiveness of topical treatments for AKs including 3{\%} diclofenac in 2.5{\%} hyaluronic acid (HA) gel, imiquimod 5{\%} cream and photodynamic therapy with methyl aminolevulinate (MAL-PDT) in the perspective of the Italian Health Care System (SSN). We used a decision tree analytical approach and efficacy data were drawn from published clinical trials. Cost was evaluated from the SSN perspective during a time horizon of 3 months. A responder was defined as a patient with all lesions clinically cleared and showing an excellent cosmetic result. Based on the applied model, the cost per complete responder was calculated. Diclofenac 3{\%} in HA was less expensive (€ 256) than MAL-PDT (€ 320) and imiquimod (€ 342). Effectiveness was similar and better for diclofenac 3{\%} in HA and MAL-PDT (0.813{\%}) in comparison to 0.734{\%} of imiquimod, respectively. The one-way and probabilistic sensitivity analyses confirmed the results of base case scenario. Based on this cost-effectiveness model, diclofenac 3{\%} in HA can be considered the treatment of choice for AK lesions and surrounding field under a pharmacoeconomic point of view.",
keywords = "Actinic, Cost-benefit analysis, Healt care costs, Keratosis",
author = "Colombo, {G. L.} and S. Chimentp and Matteo, {S. D I} and Fargnoli, {M. C.} and P. Frascione and V. Silipo and K. Peris",
year = "2010",
language = "English",
volume = "145",
pages = "573--581",
journal = "Minerva dermatologica",
issn = "0392-0488",
publisher = "Edizioni Minerva Medica S.p.A.",
number = "5",

}

TY - JOUR

T1 - Cost-effectiveness analysis of topical treatments for actinic keratosis in the perspective of the Italian health care system

AU - Colombo, G. L.

AU - Chimentp, S.

AU - Matteo, S. D I

AU - Fargnoli, M. C.

AU - Frascione, P.

AU - Silipo, V.

AU - Peris, K.

PY - 2010

Y1 - 2010

N2 - Actinie keratosis (AK) is the most common cutaneous malignant neoplasm and its prevalence continues to increase. According to the most recent findings, AK is currently considered the initial stage, in situ, of squamous cell carcinoma. Field-directed therapies for AKs are the preferred treatment since they have the advantage to clear the clinically visible lesions and also subclinical lesions within the cancerous field. We assessed the cost-effectiveness of topical treatments for AKs including 3% diclofenac in 2.5% hyaluronic acid (HA) gel, imiquimod 5% cream and photodynamic therapy with methyl aminolevulinate (MAL-PDT) in the perspective of the Italian Health Care System (SSN). We used a decision tree analytical approach and efficacy data were drawn from published clinical trials. Cost was evaluated from the SSN perspective during a time horizon of 3 months. A responder was defined as a patient with all lesions clinically cleared and showing an excellent cosmetic result. Based on the applied model, the cost per complete responder was calculated. Diclofenac 3% in HA was less expensive (€ 256) than MAL-PDT (€ 320) and imiquimod (€ 342). Effectiveness was similar and better for diclofenac 3% in HA and MAL-PDT (0.813%) in comparison to 0.734% of imiquimod, respectively. The one-way and probabilistic sensitivity analyses confirmed the results of base case scenario. Based on this cost-effectiveness model, diclofenac 3% in HA can be considered the treatment of choice for AK lesions and surrounding field under a pharmacoeconomic point of view.

AB - Actinie keratosis (AK) is the most common cutaneous malignant neoplasm and its prevalence continues to increase. According to the most recent findings, AK is currently considered the initial stage, in situ, of squamous cell carcinoma. Field-directed therapies for AKs are the preferred treatment since they have the advantage to clear the clinically visible lesions and also subclinical lesions within the cancerous field. We assessed the cost-effectiveness of topical treatments for AKs including 3% diclofenac in 2.5% hyaluronic acid (HA) gel, imiquimod 5% cream and photodynamic therapy with methyl aminolevulinate (MAL-PDT) in the perspective of the Italian Health Care System (SSN). We used a decision tree analytical approach and efficacy data were drawn from published clinical trials. Cost was evaluated from the SSN perspective during a time horizon of 3 months. A responder was defined as a patient with all lesions clinically cleared and showing an excellent cosmetic result. Based on the applied model, the cost per complete responder was calculated. Diclofenac 3% in HA was less expensive (€ 256) than MAL-PDT (€ 320) and imiquimod (€ 342). Effectiveness was similar and better for diclofenac 3% in HA and MAL-PDT (0.813%) in comparison to 0.734% of imiquimod, respectively. The one-way and probabilistic sensitivity analyses confirmed the results of base case scenario. Based on this cost-effectiveness model, diclofenac 3% in HA can be considered the treatment of choice for AK lesions and surrounding field under a pharmacoeconomic point of view.

KW - Actinic

KW - Cost-benefit analysis

KW - Healt care costs

KW - Keratosis

UR - http://www.scopus.com/inward/record.url?scp=78650737759&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78650737759&partnerID=8YFLogxK

M3 - Article

C2 - 20930692

AN - SCOPUS:78650737759

VL - 145

SP - 573

EP - 581

JO - Minerva dermatologica

JF - Minerva dermatologica

SN - 0392-0488

IS - 5

ER -