title: Photodynamic Therapy for Actinic Keratoses: A Randomized Prospective Non-sponsored Cost-effectiveness Study of Daylight-mediated Treatment Compared with Light-emitting Diode Treatment.
abstract: Daylight-mediated photodynamic therapy (DL-PDT) is considered as effective as conventional PDT using artificial light (light-emitting diode (LED)-PDT) for treatment of actinic keratoses (AK). This randomized prospective non-sponsored study assessed the cost-effectiveness of DL-PDT compared with LED-PDT. Seventy patients with 210 AKs were randomized to DL-PDT or LED-PDT groups. Effectiveness was assessed at 6 months. The costs included societal costs and private costs, including the time patients spent in treatment. Results are presented as incremental cost-effectiveness ratio (ICER). The total costs per patient were significantly lower for DL-PDT (€132) compared with LED-PDT (€170), giving a cost saving of €38 (p = 0.022). The estimated probabilities for patients' complete response were 0.429 for DL-PDT and 0.686 for LED-PDT; a difference in probability of being healed of 0.257. ICER showed a monetary gain of €147 per unit of effectiveness lost. DL-PDT is less costly and less effective than LED-PDT. In terms of cost-effectiveness analysis, DL-PDT provides lower value for money compared with LED-PDT.
authors.affiliation: Department of Dermatology and Allergology, Helsinki University and Helsinki University Hospital, FIN-00029 Helsinki, Finland. noora.neittaanmaki@fimnet.fi.
authors.forename: Noora
authors.initials: N
authors.lastname: Neittaanmäki-Perttu
authors.forename: Mari
authors.initials: M
authors.lastname: Grönroos
authors.forename: Toni
authors.initials: T
authors.lastname: Karppinen
authors.forename: Erna
authors.initials: E
authors.lastname: Snellman
authors.forename: Pekka
authors.initials: P
authors.lastname: Rissanen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D005260:Female; D017048:Health Care Costs; D006370:Heliotherapy / Q000009:adverse effects / Q000191:economics*; D006801:Humans; D055623:Keratosis, Actinic / Q000175:diagnosis / Q000191:economics* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy / Q000009:adverse effects / Q000191:economics* / Q000295:instrumentation*; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome