A trial-based cost-effectiveness analysis of topical 5-fluorouracil vs imiquimod vs ingenol mebutate vs methylaminolevulinate conventional photodynamic therapy for the treatment of actinic keratosis in the head and neck area performed in the Netherlands.

A trial-based cost-effectiveness analysis of topical 5-fluorouracil vs imiquimod vs ingenol mebutate vs methylaminolevulinate conventional photodynamic therapy for the treatment of actinic keratosis in the head and neck area performed in the Netherlands.:

Related Articles

A trial-based cost-effectiveness analysis of topical 5-fluorouracil vs imiquimod vs ingenol mebutate vs methylaminolevulinate conventional photodynamic therapy for the treatment of actinic keratosis in the head and neck area performed in the Netherlands.

Br J Dermatol. 2020 Jan 21;:

Authors: Jansen MHE, Kessels JPHM, Merks I, Nelemans PJ, Kelleners-Smeets NWJ, Mosterd K, Essers BAB

Abstract

BACKGROUND: Actinic keratosis (AK) is a common premalignant skin condition and might have the ability to progress into a squamous cell carcinoma (SCC). Due to the high incidence of AK, treatment of this disease significantly impacts healthcare spending.

OBJECTIVES: To determine which commonly prescribed field-directed treatment is the most cost-effective, when comparing 5% 5-fluorouracil (5-FU), 5% imiquimod (IMQ), 0.015% ingenol mebutate (IM), and methylaminolevulinate photodynamic therapy (MAL-PDT) for AK in the head and neck region.

METHODS: We performed an economic evaluation from a healthcare perspective. Data were collected alongside a single-blinded, prospective, multicentre randomized controlled trial with 624 participants in the Netherlands. The outcome measure was expressed in the incremental cost-effectiveness ratio (ICER), which is the incremental costs per additional patient with ≥75% lesion reduction compared to baseline.

RESULTS: The trial showed that 5-FU was the most effective field-treatment for AK in the head and neck region. Twelve months post-treatment, the total mean costs for 5-FU were significantly lower (€433), compared to €728, €775 and €1621 for IMQ, IM and MAL-PDT, respectively. The results showed that 5-FU was a dominant cost-effective (more effective and less expensive) treatment compared to the other treatments, 12 months post-treatment.

CONCLUSIONS: Based on these results, we consider 5% 5-FU cream as first choice treatment option for multiple AK in the head and neck area.

PMID: 31961446 [PubMed - as supplied by publisher]