To freeze or not to freeze: a cost-effectiveness analysis of wart treatment.
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.
Keogh-Brown
M R
MR
Department of Health Policy and Practice, School of Medicine, University of East Anglia, Norwich, NR4 7TJ, UK. m.keogh-brown@uea.ac.uk
Fordham
R J
RJ
Thomas
K S
KS
Bachmann
M O
MO
Holland
R C
RC
Avery
A J
AJ
Armstrong
S J
SJ
Chalmers
J R
JR
Howe
A
A
Rodgers
S
S
Williams
H C
HC
Harvey
I
I
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*
D000890:Anti-Infective Agents; D003879:Dermatologic Agents; D020156:Salicylic Acid