The cost of treating genital warts.
BACKGROUND
Genital warts is a common sexually transmitted disease treated by a variety of medical specialists. Standard therapies offer symptomatic relief but cannot ensure lasting remission. Using the clinical literature, claims databases, and a panel of experienced practitioners, the relative efficacy, cost, and cost effectiveness of five common treatments for genital warts were assessed in this study.


METHODS
We reviewed the clinical literature for the following genital wart therapies: podofilox, podophyllin, trichloroacetic acid, cryotherapy, and laser therapy, focusing on their relative efficacy. Physicians experienced in treating genital warts defined standard treatment protocols for men and women patients with moderate wart burdens. Using national claims data and protocols developed by physicians, we derived three economic models based on provider charges, third-party payments, and a resource-based relative value scale, respectively.


RESULTS
The literature review demonstrated highly variable success and recurrence rates among treatment methods and failed to show that one treatment provides consistently superior efficacy. In the economic models, treating women generally proved more costly than treating men per episode of care. This was due to the need for more extensive follow-up visits in the treatment of women. Total costs were highest for cryotherapy and lowest for a patient-applied therapy that reduced the need for follow-up visits.


CONCLUSIONS
Clinicians should consider both clinical and cost issues when choosing the appropriate treatment for patients with genital warts.
Strauss
M J
MJ
Health Technology Associates, Inc., Washington, District of Columbia 20005, USA.
Khanna
V
V
Koenig
J D
JD
Downs
S M
SM
Goldberg
S H
SH
Manyak
M J
MJ
Patsner
B
B
D002985:Clinical Protocols; D003218:Condylomata Acuminata / Q000191:economics* / Q000628:therapy; D003362:Cost-Benefit Analysis; D017679:Cryotherapy / Q000191:economics; D005251:Fees, Medical; D005260:Female; D005500:Follow-Up Studies; D005831:Genital Diseases, Female / Q000191:economics* / Q000628:therapy; D005832:Genital Diseases, Male / Q000191:economics* / Q000628:therapy; D017048:Health Care Costs; D006801:Humans; D007349:Insurance, Health, Reimbursement; D007641:Keratolytic Agents / Q000191:economics / Q000627:therapeutic use; D053685:Laser Therapy / Q000191:economics; D008297:Male; D018803:Models, Economic; D011033:Podophyllin / Q000191:economics / Q000627:therapeutic use; D011034:Podophyllotoxin / Q000191:economics / Q000627:therapeutic use; D012008:Recurrence; D015895:Relative Value Scales; D012074:Remission Induction; D012737:Sex Factors; D014238:Trichloroacetic Acid / Q000191:economics / Q000627:therapeutic use
D007641:Keratolytic Agents; D014238:Trichloroacetic Acid; D011033:Podophyllin; D011034:Podophyllotoxin