title: To freeze or not to freeze: a cost-effectiveness analysis of wart treatment.
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.
  
  
  OBJECTIVE
  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.
authors.affiliation: Department of Health Policy and Practice, School of Medicine, University of East Anglia, Norwich, NR4 7TJ, UK. m.keogh-brown@uea.ac.uk
authors.forename: M R
authors.initials: MR
authors.lastname: Keogh-Brown
authors.forename: R J
authors.initials: RJ
authors.lastname: Fordham
authors.forename: K S
authors.initials: KS
authors.lastname: Thomas
authors.forename: M O
authors.initials: MO
authors.lastname: Bachmann
authors.forename: R C
authors.initials: RC
authors.lastname: Holland
authors.forename: A J
authors.initials: AJ
authors.lastname: Avery
authors.forename: S J
authors.initials: SJ
authors.lastname: Armstrong
authors.forename: J R
authors.initials: JR
authors.lastname: Chalmers
authors.forename: A
authors.initials: A
authors.lastname: Howe
authors.forename: S
authors.initials: S
authors.lastname: Rodgers
authors.forename: H C
authors.initials: HC
authors.lastname: Williams
authors.forename: I
authors.initials: I
authors.lastname: Harvey
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D017679:Cryotherapy / Q000191:economics*; D003879:Dermatologic Agents / Q000191:economics* / Q000627:therapeutic use*; D006801:Humans; D020156:Salicylic Acid / Q000191:economics* / Q000627:therapeutic use; D016896:Treatment Outcome; D014860:Warts / Q000628:therapy*
chemical_list: D000890:Anti-Infective Agents; D003879:Dermatologic Agents; D020156:Salicylic Acid