The cost-effectiveness of patient-applied treatments for anogenital warts.
A model was developed to estimate the cost-effectiveness of podophyllotoxin and imiquimod for self-treatment of anogenital warts. The effectiveness endpoint was sustained clearance after treatment and a subsequent follow-up period of approximately 12 weeks. Effectiveness of podophyllotoxin was estimated from a quantitative summary of nine placebo-controlled trials, while effectiveness of imiquimod was based on a quantitative summary of six placebo-controlled trials. Costs were considered from a UK health service provider perspective; drug acquisition costs were obtained from the British National Formulary and health service costs of clinic attendance were based on a recent survey of GUM clinics. The impact of uncertainty was explored in a wide range of one-way and probabilistic (multi-way) sensitivity analyses. The cost per sustained clearance was 313 for podophyllotoxin and 606 for imiquimod. The modest and statistically insignificant incremental effectiveness of imiquimod was purchased at high cost-2476 per additional sustained clearance. Sensitivity analyses showed the economic superiority of podophyllotoxin to be robust and statistically very significant.
Williams
Paul
P
PAREXEL MMS, Uxbridge, UK. paul.williams@parexel.com
von Krogh
Geo
G
D000634:Aminoquinolines / Q000191:economics / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000191:economics / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003362:Cost-Benefit Analysis; D006801:Humans; D000077271:Imiquimod; D007121:Immunocompetence; D011034:Podophyllotoxin / Q000191:economics / Q000627:therapeutic use; D012648:Self Care / Q000191:economics*; D014860:Warts / Q000188:drug therapy / Q000191:economics*
D000634:Aminoquinolines; D000970:Antineoplastic Agents; D011034:Podophyllotoxin; D000077271:Imiquimod