The cost-effectiveness of rosacea treatments.
BACKGROUND
Topical and oral antibiotic/anti-inflammatory agents are mainstays of therapy for rosacea. However, costs and efficacies of these therapies vary widely.


OBJECTIVE
To determine relative cost-effectiveness of common therapeutic regimens using published data.


METHODS
Average daily costs (ADC) were determined based on treatment frequency and estimated gram usage for facial application of topical regimens of metronidazole (0.75%, 1%), azelaic acid (15%, 20%), sodium sulfacetamide and sulfur 10%/5%, and oral regimens of tetracycline, doxycycline, and isotretinoin. The ADC was compared with published efficacy rates from clinical trials, with efforts to standardize outcome measures. Based on these efficacy rates, costs per success were calculated and combined with office visit costs to estimate the total cost for each treatment for a 15-week period.


RESULTS
The medication cost per treatment success of topical regimens ranged from $60.90 ($205.40, total, including office visits) for metronidazole 1% gel once daily, to $152.25 ($296.75, total) for azelaic acid 20% cream twice daily. Tetracycline 250 mg/day was the least costly oral agent at $6.30 per treatment success, or $150.80 total.


CONCLUSIONS
Based on our best assessments of retrospective data from the literature, metronidazole 1% gel, once daily, was considerably less costly than several other branded and generic alternatives.
Thomas
Kristen
K
Department of Dermatology, Wake Forest University School of Medicine, The Ohio State University Colleges of Pharmacy, Columbus, Ohio, USA.
Yelverton
Christopher B
CB
Yentzer
Brad A
BA
Balkrishnan
Rajesh
R
Fleischer
Alan B
AB
Feldman
Steven R
SR
D000284:Administration, Oral; D000287:Administration, Topical; D000900:Anti-Bacterial Agents / Q000191:economics* / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000191:economics* / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D017046:Cost Savings; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D004334:Drug Administration Schedule; D016527:Drug Costs / Q000706:statistics & numerical data*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000191:economics / Q000627:therapeutic use; D012393:Rosacea / Q000188:drug therapy* / Q000191:economics; D013997:Time Factors; D014481:United States
D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D008795:Metronidazole