Derm News: 2007.17(10)

To freeze or not to freeze: a cost-effectiveness analysis of wart treatment

British Journal of Dermatology, 156(4):687-692
M.R. Keogh-Brown, R.J. Fordham, K.S. Thomas, M.O. Bachmann, R.C. Holland, A.J. Avery, S.J. Armstrong, J.R. Chalmers, A. Howe, S. Rodgers, H.C. Williams, I. Harvey
ABSTRACT

Background

Several general practitioner (GP)-prescribed and over-the-counter therapies for warts and verrucae are available. However, the cost-effectiveness of these treatments is unknown.

Objectives

To compare the cost-effectiveness of different treatments for cutaneous warts.

Methods

We designed a decision-analytic Markov simulation model based on systematic review evidence to estimate the cost-effectiveness of various treatments. The outcome measures studied are percentage of patients cured, cost of treatment and incremental cost-effectiveness ratio for each treatment, compared with no treatment, after 18 weeks.

Results

Duct tape was most cost-effective but published evidence of its effectiveness is sparse. Salicylic acid was the most cost-effective over-the-counter treatment commonly used. Cryotherapy administered by a GP was less cost-effective than GP-prescribed salicylic acid and less cost-effective than cryotherapy administered by a nurse.

Conclusions

Duct tape could be adopted as the primary treatment for cutaneous warts if its effectiveness is verified by further rigorous trials. Nurse-administered cryotherapy is likely to be more cost-effective than GP-administered cryotherapy.

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The Derm News service provided by the Editorial Consultants of Skin Therapy Letter^© and its founding editor Dr. Stuart Maddin.